Stacey Jackson

Registered Nurse · Minot, ND

Individual Active NPI

NPI number 1508301292

Practice location

1015 S Broadway
Suite 18
Minot, ND 58701-4667
Phone
(701) 857-8500
Fax
(701) 857-8555

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NPI record

NPI
1508301292
Entity type
Individual (Type 1)
Enumeration date
January 4, 2017
Last updated
January 4, 2017
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Registered Nurse Primary 163W00000X R38052 ND

About Stacey Jackson

Stacey Jackson is a healthcare provider registered in the NPI registry with the primary taxonomy Registered Nurse (code 163W00000X). The practice location is 1015 S Broadway, Suite 18, Minot, ND 58701-4667. The NPI number 1508301292 was assigned on January 4, 2017 and the record was last updated on January 4, 2017.

Stacey Jackson lists a license in the registry: #R38052 (ND) for Registered Nurse. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Stacey Jackson?

The NPI number is 1508301292.

What is the phone number of Stacey Jackson?

The phone number listed for the practice location is (701) 857-8500.

Where is Stacey Jackson located?

1015 S Broadway, Suite 18, Minot, ND 58701-4667.

What is the taxonomy code for Stacey Jackson?

The primary taxonomy code is 163W00000X – Registered Nurse.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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