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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. SHINIECE NICOLE JACKSON

Deactivated Sole Proprietor

MS. SHINIECE NICOLE JACKSON is a Licensed Practical Nurse healthcare provider located in SYRACUSE, New York. NPI 1063668051 is deactivated in the NPPES registry. Verify at CMS.

Licensed Practical Nurse · SYRACUSE, NY

This NPI has been deactivated. The record was deactivated on November 1, 2011. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1063668051
Provider Type
Individual
Gender
Female
NPI Issued
Aug 11, 2008 (3.224043715847 yrs)
Last Updated
Feb 15, 2022
Deactivated
Nov 1, 2011
License
263257-1 (NY)
Sole Proprietor
Yes

Practice Information

Address
5813 S SALINA ST
SYRACUSE, NY, 132053264
Browse NY providers · Browse ZIP 13205
Phone
3153804864
Primary Specialty
Licensed Practical Nurse
164W00000X

Other Licensed Practical Nurse Providers in SYRACUSE, NY

Name Credential NPI
MS. PATRICIA ANN WENTZEL L.P.N. 1346340999
NOELLE BRENNAN LPN 1871662072
MS. MARY E. WILMOT LPN 1053481721
SHARON L JOHN LPN 1699849257
MS. NICOLE CHRISTINE CLARK LPN 1982767604
TRACI ANN MOWRY LPN 1700919198
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.