Nicole L Jackson , LPN
Licensed Practical Nurse • Tontogany, OH
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Nicole Jackson has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Nicole Jackson, LPN was a registered Licensed Practical Nurse practicing in Tontogany, OH. Throughout an active medical career spanning 14 years, Nicole Jackson provided care at the practice location at 18680 MAIN STREET until profile deactivation on 2023-05-17.
Practice Location & Contact Primary Location
18680 Main Street
Tontogany, OH 43565
Specialty Benchmarks & Practice Insights
Comparative analytics for Licensed Practical Nurse in Tontogany, OH
Practicing in Tontogany, OH (13034 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 164W00000X
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.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on May 17, 2023
NPI status registered as active in NPPES database
Registered at 18680 MAIN STREET, TONTOGANY, OH 43565 (Tel: 4192760447)
Registered at PO BOX 226, TONTOGANY, OH 435650226 (Tel: 4192760447)
Recorded as NICOLE JACKSON, LPN
Licensed Practical Nurse (License #135313 in OH)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
Po Box 226
Tontogany, OH 435650226
Phone: 4192760447
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