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

MRS. TRACI JACKSON, LPN

Active Sole Proprietor

MRS. TRACI JACKSON, LPN is a Licensed Practical Nurse healthcare provider located in MUNNSVILLE, New York. NPI 1821340498 is currently active in the NPPES registry. Verify at CMS.

Licensed Practical Nurse · MUNNSVILLE, NY

Registration Details

NPI Number
1821340498
Provider Type
Individual
Gender
Female
NPI Issued
Oct 8, 2012 (13.86515913288 yrs)
Last Updated
Oct 8, 2012
License
311477 (NY)
Sole Proprietor
Yes

Practice Information

Address
6462 MORRIS RD
MUNNSVILLE, NY, 134094122
Browse NY providers · Browse ZIP 13409
Phone
3152648316
Primary Specialty
Licensed Practical Nurse
164W00000X

Other Licensed Practical Nurse Providers in MUNNSVILLE, NY

Name Credential NPI
MELISSA SCHON 1235615436
AMANDA WEST 1417779992
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.