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ELISSA JACKSON LPN
NPI 1558909473
Licensed Practical Nurse in Mentor, OH

Active since December 11, 2019
7232 JUSTIN WAY, MENTOR, OH 44060(440) 578-8200 Get Directions Write a Review

NPPES record last updated: September 16, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 16, 2022, Jan 28, 2021, Jan 21, 2021 and 1 more (4 updates tracked since 2019).

About Elissa Jackson Lpn NPPES

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

ELISSA JACKSON LPN (NPI 1558909473) is an individual licensed practical nurse in Mentor, Ohio, licensed in Ohio (LPN.148984.MEDS-IV) and active in the NPI registry since December 2019.

NPPES Registry Identity

NPI1558909473
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameELISSA JACKSONCredential: LPN
Location Address7232 JUSTIN WAYMentor, OH 44060-4881
Mailing Address7232 Justin WayMentor, OH 44060-4881 · (440) 578-8200
Phone(440) 578-8200
Sole ProprietorNo
Enumeration DateDecember 11, 2019
Last NPPES UpdateSeptember 16, 20224 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2022
✔ NPI 1558909473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in OH · LPN.148984.MEDS-IV
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.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
7232 JUSTIN WAY, Mentor, OH 44060
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Other Identifiers 1

Medicaid0430027OH

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TIFFANY JONES M.D.
Psychiatry & Neurology (Psychiatry)
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
ASHLEY NICHOLE FOCHT
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
MRS. FATIMAAH D FULLILOVE LSW, LICDC
Social Worker (Clinical)
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
THERESA GILL LPCC
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
JAMIE GAMBRELL
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
CLOTILDA J RAYMOND
Social Worker
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
BRENDA BERRY SAMPLE
Case Manager/Care Coordinator
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
KIMBERLEE BIZUP LPCC-S
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200

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 Elissa Jackson's NPI number?

The NPI number for Elissa Jackson is 1558909473. It was assigned to this individual provider in the NPPES registry on December 11, 2019.

Where is Elissa Jackson located?

Elissa Jackson practices at 7232 Justin Way, Mentor, OH 44060. The listed phone number is (440) 578-8200.

What is Elissa 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 Elissa Jackson was last updated on September 16, 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.