Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacksonscott2

Organization Pediatric Skilled Nursing Facility · NPI 1154869410

Jacksonscott2 is a Pediatric Skilled Nursing Facility in Milwaukee, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2017.

Licensed in
WI
In the registry since
2017

Practice location Address checks out

4573 N 22nd St
Milwaukee, WI 53209
Phone: (414) 517-2825
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Skilled Nursing Facility (primary) Taxonomy 3140N1450X · Licence 317445-31 (WI)

Record details

NPI number1154869410
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Latasha Jackson — Lpn · (414) 517-2825
NPI enumeratedFebruary 7, 2017
Last updated in NPPESFebruary 7, 2017
Mailing address4573 N 22nd St, Milwaukee, WI 53209-6309

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