Dr. Lastasha R Jackson, CRNP
Dr. Lastasha R Jackson, CRNP is a Nurse Practitioner in Woodlyn, Pennsylvania. Qualified in 2021, 5 years ago. Practices with Avenues Recovery Medical Center at Valley Forge, a 22-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.
- Years since qualifying
- 5
- Licensed in
- PA
- In the registry since
- 2021
What do these letters mean?
- CRNP — Certified Registered Nurse Practitioner
- The title Pennsylvania and some other states use for a nurse practitioner.
Practice location Address checks out
215 Bullens LnWoodlyn, PA 19094-2001
Phone: (484) 416-0769
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Nurse Practitioner (primary) | Taxonomy 363LF0000X · Licence SP022131 (PA) |
|---|
Record details
| NPI number | 1356911325 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | CRNP |
| Sole proprietor | Yes |
| NPI enumerated | June 30, 2021 |
| Last updated in NPPES | June 30, 2021 |
| Certification date | June 4, 2021 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2021 (5 years in practice) |
| Group practice | Avenues Recovery Medical Center At Valley Forge — 22 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Woodlyn
-
Demi Baylee Lira, CRNP
1363 Valley Rd, Woodlyn, PA 19094-1123 · (484) 620-5317