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

Lisa D Jackson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1124834858

Lisa D Jackson is a Student in an Organized Health Care Education/Training Program in Clinton, Maryland. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2

Practice location Address checks out

9134 Piscataway Rd Unit 371
Clinton, MD 20735-7615
Phone: (240) 444-5976
Show map & directions

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

Specialties & licences

Health & Wellness Coach (primary) Taxonomy 171400000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1124834858
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 7, 2024
Last updated in NPPESDecember 7, 2024
Certification dateDecember 6, 2024
Mailing address9134 Piscataway Rd Unit 371, Clinton, MD 20735-7615

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