DOMINIQUE JAQUETTA NICOLE BUCKNER NPI 1508504515

NPI Information

NPI: 1508504515
Provider Name: DOMINIQUE JAQUETTA NICOLE BUCKNER
Classification: Licensed Practical Nurse - 164W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
655 MEADOWBROOK RD
JACKSON, MS
ZIP 39206
Phone: (601) 882-4878
Get Directions

Dominique Jaquetta Nicole Buckner is a licensed practical nurse in Jackson, MS. The provider is 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. Dominique Jaquetta Nicole Buckner NPI is 1508504515. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

655 MEADOWBROOK RD
JACKSON, MS
ZIP 39206-842
Phone: (601) 882-4878

The NPI 1508504515 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 5/20/2022 and was last updated on 3/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	164W00000X	Licensed Practical Nurse		337392	MISSISSIPPI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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