MS. SERIDA MARIE JACKSON LPN
NPI 1154841120
Licensed Practical Nurse in Valley Stream, NY

Q: What is Serida Jackson's NPI number?

The NPI number for Serida Jackson is 1154841120. It was assigned to this individual provider in the NPPES registry on June 21, 2017.

Q: What is Serida Jackson's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Serida Jackson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 21, 2017

106 COUNTISBURY AVE, VALLEY STREAM, NY 11580(516) 270-0943 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jun 21, 2017 (2 updates tracked since 2017).

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About Ms. Serida Marie Jackson Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SERIDA MARIE JACKSON LPN (NPI 1154841120) is an individual licensed practical nurse in Valley Stream, New York, licensed in New York (328081) and active in the NPI registry since June 2017.

NPPES Registry Identity

NPI1154841120

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameMS. SERIDA MARIE JACKSONCredential: LPN

Location Address106 COUNTISBURY AVEValley Stream, NY 11580-1748

Mailing Address106 Countisbury AveValley Stream, NY 11580-1748 · (516) 270-0943

Phone(516) 270-0943

Sole ProprietorNo

Enumeration DateJune 21, 2017

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1154841120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in NY · 328081

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

106 COUNTISBURY AVE, Valley Stream, NY 11580

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Other Identifiers 1

Medicaid124742419NY

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Serida Jackson's NPI number?

The NPI number for Serida Jackson is 1154841120. It was assigned to this individual provider in the NPPES registry on June 21, 2017.

Where is Serida Jackson located?

Serida Jackson practices at 106 Countisbury Ave, Valley Stream, NY 11580. The listed phone number is (516) 270-0943.

What is Serida Jackson's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Serida Jackson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.