National Provider Identifier
Shaquan Jackson
Shaquan Jackson is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 615-4905.
Profile Overview
- NPI
- 1730818691
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- June 07, 2022
- Last Updated
- June 07, 2022
Practice Location
- 214 Saint Patrick Dr
- Rochester, NY 14623-3730
Phone: (585) 615-4905
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1730818691
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Shaquan
- Mailing Street Address
- 214 Saint Patrick Dr
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14623-3730
- Mailing Country
- US
- Mailing Phone
- (585) 615-4905
- Practice Street Address
- 214 Saint Patrick Dr
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14623-3730
- Practice Country
- US
- Practice Phone
- (585) 615-4905
- Enumeration Date
- June 07, 2022
- Last Updated
- June 07, 2022
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- June 07, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)