Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. LARRY RANDOLPH JACKSON, REGISTERED NURSE
Active Sole ProprietorChild & Adolescent Psychiatric Nurse · COLUMBIA, SC
Registration Details
- NPI Number
- 1093878191
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 19, 2006 (19.372112580308 yrs)
- Last Updated
- Jul 8, 2007
- License
-
56879 (SC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
615 RAPIDS RDCOLUMBIA, SC, 292123024Browse SC providers · Browse ZIP 29212
- Phone
- 8037982211
- Primary Specialty
-
Child & Adolescent Psychiatric Nurse
163WP0808X
Other Child & Adolescent Psychiatric Nurse Providers in COLUMBIA, SC
| Name | Credential | NPI |
|---|---|---|
| MRS. RAMONA BOULWARD COPELAND | R.N. | 1689690364 |
| MRS. DELINDA CORLEY HICKS | RN,C | 1962591305 |
| NANCY RAGAN CANADAY | R.N.,C | 1477629582 |
| MS. MONICA JEAN DAVIS | RN | 1962562777 |
| DR. FREDRICK J. ASTLE | PHD, APRN, PMHCNS-BC | 1750575338 |
| MS. DOROTHY E. VAUGHAN | REGISTERED NURSE | 1922275155 |
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.