Mrs Traci Jackson, LPN is a
Licensed Practical Nurse based in Munnsville, New York. Mrs Traci Jackson is licensed to practice in New York (license number 311477) and her current practice location is
6462 Morris Rd, Munnsville, New York. She can be reached at her office (for appointments etc.) via phone at
(315) 264-8316.
NPI number for Mrs Traci Jackson is 1821340498 and her current mailing address is 6462 Morris Rd, Munnsville, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1821340498.
Provider's Profile
Full Name | Mrs Traci Jackson |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 6462 Morris Rd, Munnsville, New York |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1821340498
- Provider Enumeration Date: 10/08/2012
- Last Update Date: 10/08/2012
Medical Identifiers
Medical identifiers for Mrs Traci Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1821340498 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 311477 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Traci Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Traci Jackson, LPN 6462 Morris Rd, Munnsville, NY 13409 Ph: (315) 264-8316 | Mrs Traci Jackson, LPN 6462 Morris Rd, Munnsville, NY 13409-4122 Ph: (315) 264-8316 |
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