National Provider Identifier

Tracey Monique Jackson, RN

Tracey Monique Jackson, RN is listed in the NPPES registry with a primary specialty of Registered Nurse in Rochester, NY and a listed phone number of (585) 509-7183.

NPI 1609063882Rochester, NYRegistered Nurse

Profile Overview

NPI
1609063882
Provider Type
Individual
Primary Specialty
Registered Nurse
Enumeration Date
October 01, 2007
Last Updated
October 01, 2007

Practice Location

  • 23 Flanders St
  • Rochester, NY 14619-1705

Phone: (585) 509-7183

Specialties

  • Registered Nurse (163W00000X)
Full Record
NPI
1609063882
Entity Type
Individual
Last Name
Jackson
First Name
Tracey
Middle Name
Monique
Name Prefix
Mrs.
Credential
RN
Mailing Street Address
23 Flanders St
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14619-1705
Mailing Country
US
Mailing Phone
(585) 509-7183
Practice Street Address
23 Flanders St
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14619-1705
Practice Country
US
Practice Phone
(585) 509-7183
Enumeration Date
October 01, 2007
Last Updated
October 01, 2007
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Registered Nurse (163W00000X)
Other Identifiers
01959764 (NY)