National Provider Identifier

Holly Jean Jackson, LPN

Holly Jean Jackson, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Canandaigua, NY and a listed phone number of (585) 905-1307.

NPI 1417351453Canandaigua, NYLicensed Practical Nurse

Profile Overview

NPI
1417351453
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
October 20, 2014
Last Updated
October 20, 2014

Practice Location

  • 5A Lafayette Avenue
  • Canandaigua, NY 14424

Phone: (585) 905-1307

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1417351453
Entity Type
Individual
Last Name
Jackson
First Name
Holly
Middle Name
Jean
Credential
LPN
Mailing Street Address
5A Lafayette Avenue
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424
Mailing Country
US
Mailing Phone
(585) 905-1307
Practice Street Address
5A Lafayette Avenue
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424
Practice Country
US
Practice Phone
(585) 905-1307
Enumeration Date
October 20, 2014
Last Updated
October 20, 2014
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)