National Provider Identifier

Lisa Jaeckle

Lisa Jaeckle is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Jamestown, NY and a listed phone number of (716) 487-1131.

NPI 1003356072Jamestown, NYLicensed Practical Nurse

Profile Overview

NPI
1003356072
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
February 24, 2017
Last Updated
February 24, 2017

Practice Location

  • 220 Fluvanna Ave
  • Jamestown, NY 14701-2052

Phone: (716) 487-1131

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1003356072
Entity Type
Individual
Last Name
Jaeckle
First Name
Lisa
Mailing Street Address
220 Fluvanna Ave
Mailing City
Jamestown
Mailing State
NY
Mailing ZIP Code
14701-2052
Mailing Country
US
Practice Street Address
220 Fluvanna Ave
Practice City
Jamestown
Practice State
NY
Practice ZIP Code
14701-2052
Practice Country
US
Practice Phone
(716) 487-1131
Enumeration Date
February 24, 2017
Last Updated
February 24, 2017
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)