SHANTE OCTAVIA JACKSON LPN
NPI 1982594313
Home Health in Phila, PA
- Individual
- Female
- Home Health
About SHANTE JACKSON
This page provides the complete NPI Profile along with additional information for Shante Jackson, a provider established in Phila, Pennsylvania with a medical specialization in Home Health. The healthcare provider is registered in the NPI registry with number 1982594313 assigned on July 2025. The practitioner's primary taxonomy code is 251E00000X with license number LPN303611 (PA). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1982594313 Verify this NPI
- Provider Name
- SHANTE OCTAVIA JACKSON LPN
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 50 E WILLOW GROVE AVE APT 1 PHILA, PA 19118
- Location Phone
- (856) 514-0073
- Mailing Address
- 50 E WILLOW GROVE AVE APT 1 PHILA, PA 19118
- Mailing Phone
- (856) 514-0073
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-07-2025
- Last Update Date
- 07-07-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Home Health
- Taxonomy Code
- 251E00000X
- Type
- Agencies
- License No.
- LPN303611
- License State
- PA
- Taxonomy Description
- A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982594313, enumerated as an "individual" on July 07, 2025.
The provider is located at 50 E WILLOW GROVE AVE APT 1 PHILA, PA 19118 and the phone number is (856) 514-0073.
Home Health with taxonomy code 251E00000X.
