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

Shante Octavia Jackson, LPN

Individual provider Licensed Practical Nurse · NPI 1982594313

Shante Octavia Jackson, LPN is a Licensed Practical Nurse in Phila, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2025
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

See every abbreviation used in this directory →

Practice location Address checks out

50 E Willow Grove Ave Apt 1
Phila, PA 19118-3464
Phone: (856) 514-0073
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence LPN303611 (PA)

Record details

NPI number1982594313
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPN
Sole proprietorYes
NPI enumeratedJuly 7, 2025
Last updated in NPPESJuly 23, 2026
Certification dateJuly 23, 2026

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