Krista Jackson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN139496 Issued in OH

Practice address

4872 Debbie Dr
Medina, OH 44256-8675

Phone

(330) 321-4012

NPI assigned

Nov 23, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1385164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385164800000",
    "number": "1972933216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4872 DEBBIE DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4872 DEBBIE DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568675",
            "telephone_number": "330-321-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-23",
        "last_updated": "2013-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN139496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Counseling LLC
• Intervention for Peace Inc.
• Helen F Jablonowski, RN
• Laura Rae Jackam, P.A.
• Glenna S Jackson, M.D.
• Qiana Caprice Jackson
• Raytionna Danielle Jackson
• Sarah Murtha Jackson
• Jacqueline Marie Jacob
• Dennette Kaye Jacoby

• Licensed Practical Nurse in Medina, OH
• Providers in Medina, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.