Doctor Name: | MS. KIMBERLY MONIWUE GILMORE JACKSON |
NPI Number: | 1811290141 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN |
License Number: | 2785861 |
Business Practice Address: | 5285 Lewiston Rd Lewiston, NY - 140921942 |
Business Phone Number: | 7162982900 |
Business Fax Number: | 7162983815 |
Mailing Address: | 8521 Porter Rd Apt 108, NIAGARA FALLS |
State: | NY |
Postal Code: | 143041631 |
Phone Number: | 7162976075 |
Fax Number: | 7162983815 |
NPI Enumeration Date: | 12/08/2010 |
NPI Last Update Date: | 12/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 2785861 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |