Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1518178870 Individual Practitioner Female Practitioner

Jacklyn Elaine Petersen , LPN

Licensed Practical Nurse • Holland, OH

Professional Overview & Biography Verified Profile Summary

Jacklyn Petersen, LPN is a registered healthcare professional specializing in Licensed Practical Nurse in Holland, OH. Practice services are available at 1905 PERRYSBURG HOLLAND RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1905 Perrysburg Holland Rd

Holland, OH 435289582

Telephone 4193240949
Associated Practice Facility / Clinic
🏢 Lutheran Homes Society, Inc. Facility NPI 1245262799

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Holland, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.0 Yrs
Regional Practice Density
25 Specialists

Practicing in Holland, OH (13034 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-06-09
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License OH LPN.110467.MEDS

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.

Licensed Practical Nurse

NUCC Taxonomy Code: 164W00000X

State License OH PN-110467

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.

Secondary Practice Locations

48 W Main St

Leipsic, OH 458561128

Phone: 4199433639

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Shadora Crockett , LMSW, LSW

Social Worker - Clinical

NPI 1174008726

Licensed Master Social Worker, Licensed Social Worker

Johnathan Nichols

Case Manager/Care Coordinator

NPI 1245190172
Jessica Queen , LPN

Licensed Practical Nurse

NPI 1871162107

Licensed Practical Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 09, 2025

Registered at 1905 PERRYSBURG HOLLAND RD, HOLLAND, OH 435289582 (Tel: 4193240949)

📍
Updated Business Mailing Address June 09, 2025

Registered at 1905 PERRYSBURG HOLLAND RD, HOLLAND, OH 435289582 (Tel: 4193240949)

👤
Provider Name / Credentials Updated June 09, 2025

Recorded as JACKLYN PETERSEN, LPN

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 48 W MAIN ST, LEIPSIC, OH 458561128 (Tel: 4199433639)

📍
Updated Business Mailing Address July 08, 2007

Registered at 48 W MAIN ST, LEIPSIC, OH 458561128 (Tel: 4199433639)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JACKLYN GARCIA, LPN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Licensed Practical Nurse (License #PN-110467 in OH)

🟢
Initial NPI Registration & Enumeration May 25, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1518178870
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 25, 2007
Last Update: June 09, 2025
Sole Proprietor: Yes

Mailing Address

1905 Perrysburg Holland Rd

Holland, OH 435289582

Phone: 4193240949

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.