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DOMINIQUE JAQUETTA NICOLE BUCKNER
NPI 1508504515
Licensed Practical Nurse in Jackson, MS

Active since May 20, 2022
655 MEADOWBROOK RD, JACKSON, MS 39206(601) 882-4878 Get Directions Write a Review

NPPES record last updated: March 20, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2023, May 20, 2022 (2 updates tracked since 2022).

About Dominique Jaquetta Nicole Buckner NPPES

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

DOMINIQUE JAQUETTA NICOLE BUCKNER (NPI 1508504515) is an individual licensed practical nurse in Jackson, Mississippi, licensed in Mississippi (337392) and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1508504515
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameDOMINIQUE JAQUETTA NICOLE BUCKNER
Location Address655 MEADOWBROOK RDJackson, MS 39206-5842
Mailing Address655 Meadowbrook RdJackson, MS 39206-5842 · (601) 882-4878
Phone(601) 882-4878
Sole ProprietorNo
Enumeration DateMay 20, 2022
Last NPPES UpdateMarch 20, 20232 updates tracked since enumeration
NPPES CertifiedMarch 20, 2023
✔ NPI 1508504515 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 MS · 337392
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.
655 MEADOWBROOK RD, Jackson, MS 39206
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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 Dominique Buckner's NPI number?

The NPI number for Dominique Buckner is 1508504515. It was assigned to this individual provider in the NPPES registry on May 20, 2022.

Where is Dominique Buckner located?

Dominique Buckner practices at 655 Meadowbrook Rd, Jackson, MS 39206. The listed phone number is (601) 882-4878.

What is Dominique Buckner'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 Dominique Buckner was last updated on March 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.