National Provider Identifier
Kelley R Jackson, LPN
Kelley R Jackson, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Buffalo, NY and a listed phone number of (480) 233-0850.
Profile Overview
- NPI
- 1538586755
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- March 26, 2014
- Last Updated
- March 26, 2014
Practice Location
- 32 Ericson Ave
- Buffalo, NY 14215-3808
Phone: (480) 233-0850
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1538586755
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Kelley
- Middle Name
- R
- Credential
- LPN
- Mailing Street Address
- 32 Ericson Ave
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14215-3808
- Mailing Country
- US
- Mailing Phone
- (480) 233-0850
- Practice Street Address
- 32 Ericson Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14215-3808
- Practice Country
- US
- Practice Phone
- (480) 233-0850
- Enumeration Date
- March 26, 2014
- Last Updated
- March 26, 2014
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)