Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Demetrius Emmanuel Jackson

Individual provider Pediatric Registered Nurse · NPI 1922902287

Demetrius Emmanuel Jackson is a Pediatric Registered Nurse in Madison, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2026.

Licensed in
WI
In the registry since
2026

Practice location Address checks out

138 Alton Dr
Madison, WI 53718-9156
Phone: (757) 915-0633
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Registered Nurse (primary) Taxonomy 163WP0200X · Licence 1102063-30 (WI)

Record details

NPI number1922902287
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 7, 2026
Last updated in NPPESOctober 7, 2026
Certification dateOctober 7, 2026

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