Individual provider · Type 1 NPI

Tana Jackson-Wilson

Licensed Practical Nurse · Phoenix, AZ

NPI number 1639504152 Active

Practice location

4612 N 28th St, Camelback Hs Medically Fragile
Phoenix, AZ 85016-4931

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000XLP048815 (AZ)
Licensed Practical Nurse 164W00000X043114639 (IL)

Licensed Practical Nurse: An individual 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.

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About NPI 1639504152

Tana Jackson-Wilson's National Provider Identifier is 1639504152, issued on Sep 4, 2013. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Phoenix, AZ. The record was last updated on Sep 4, 2013.