Individual provider · Type 1 NPI

Ralph Jackson

Licensed Practical Nurse · Syracuse, NY

NPI number 1720107675 Active

Practice location

813 Fay Rd
Syracuse, NY 13219-3009

Call (315) 488-2831 Map

Mailing address

PO Box 494, Syracuse
Syracuse, NY 13201-0494

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X265882 (NY)

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 1720107675

Ralph Jackson's National Provider Identifier is 1720107675, issued on Mar 29, 2007. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Syracuse, NY. The record was last updated on Jul 8, 2007.