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Ms. Shatonne Dianne Jackson, LPN
Nursing Facility/Intermediate Care Facility in Dayton, Ohio
NPI 1568897783

Shatonne Dianne Jackson is a Nursing Facility/Intermediate Care Facility based in Dayton, OH. Shatonne Dianne Jackson practices in Dayton, OH and has the professional credentials of LPN. The NPI Number for Shatonne Dianne Jackson is 1568897783 and holds a License No. 149943 (Ohio).

The current practice location address for Shatonne Dianne Jackson is 616 Ellsworth Dr, Dayton, OH and can be reached out via phone at 937-581-5081. You can also correspond with Shatonne Dianne Jackson through the mailing address at 616 ELLSWORTHY DR, DAYTON, OH - 45426 (mailing address contact number: 937-581-5081).

Location: 616 Ellsworth Dr, Dayton, OH, 45426
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568897783
Provider Name
Shatonne Dianne Jackson
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
616 Ellsworth Dr, Dayton, OH, 45426
Phone Number
937-581-5081
Fax Number
Provider Enumeration Date
09/06/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
616 Ellsworth Dr
City
Dayton
State
Ohio
Zip
45426
Phone Number
937-581-5081
Fax Number
person
Provider Business Mailing Address Details
Address
616 Ellsworth Dr
City
Dayton
State
Ohio
Zip
45426
Phone Number
937-581-5081
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Nursing Facility/Intermediate Care Facility
Speciality
-
Taxonomy
313M00000X
License No.
149943 (Ohio)
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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