Provider Demographics
NPI:1881932176
Name:RAMKISON, JACQUELINE (CNA)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:RAMKISON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GILL AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-2545
Mailing Address - Country:US
Mailing Address - Phone:516-208-6537
Mailing Address - Fax:
Practice Address - Street 1:16 GILL AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-2545
Practice Address - Country:US
Practice Address - Phone:516-208-6537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330131821189E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide