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JACKIE NICKERSON
NPI 1184510117
Technician - Personal Care Attendant in Jacksonburg, WV

Active since June 16, 2025
59071 CROZIER RD, JACKSONBURG, WV 43933(740) 579-2697 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jackie Nickerson NPPES

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

JACKIE NICKERSON (NPI 1184510117) is an individual personal care attendant in Jacksonburg, West Virginia and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1184510117
Entity TypeIndividualFemale
Primary Taxonomy3747P1801X
Provider Legal NameJACKIE NICKERSON
Location Address59071 CROZIER RDJacksonburg, WV 43933
Mailing Address59071 Crozier RdJacksonburg, WV 43933 · (740) 579-2697
Phone(740) 579-2697
Sole ProprietorNo
Enumeration DateJune 16, 2025
NPPES CertifiedMay 29, 2025
✔ NPI 1184510117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician · Personal Care AttendantNursing Service Related Providers
Taxonomy Code3747P1801X
Definition
An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards
59071 CROZIER RD, Jacksonburg, WV 43933
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Other Identifiers 3

Medicaid125553494WV
Medicaid1356607394WV
Medicaid1821206228WV

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 Jackie Nickerson's NPI number?

The NPI number for Jackie Nickerson is 1184510117. It was assigned to this individual provider in the NPPES registry on June 16, 2025.

Where is Jackie Nickerson located?

Jackie Nickerson practices at 59071 Crozier Rd, Jacksonburg, WV 43933. The listed phone number is (740) 579-2697.

What is Jackie Nickerson's specialty?

The primary specialty registered for this NPI is Technician, specializing in Personal Care Attendant, with taxonomy code 3747P1801X.

When was this NPI record last updated?

The NPPES record for Jackie Nickerson was last updated on June 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.