DR. STACEY FAITH JACKSON DO - NPI 1205539640 - Student in an Organized Health Care Education/Training Program in New Hyde Park, NY

Q: What is Stacey Jackson's NPI number?

The NPI number for Stacey Jackson is 1205539640. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Q: What is Stacey Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Stacey Jackson was last updated on March 24, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Stacey Faith Jackson Do NPPES

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

DR. STACEY FAITH JACKSON DO (NPI 1205539640) is an individual student in an organized health care education/training program in New Hyde Park, New York and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1205539640

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. STACEY FAITH JACKSONCredential: DO

Location Address26901 76TH AVENew Hyde Park, NY 11040-1433

Mailing Address26901 76th Ave Rm C028New Hyde Park, NY 11040-1433 · (718) 470-8284

Phone(718) 470-8284

Sole ProprietorNo

Enumeration DateMarch 24, 2023

NPPES CertifiedMarch 24, 2023

✔ NPI 1205539640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

26901 76TH AVE, New Hyde Park, NY 11040

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