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

Miss. Crystal Jackson, NDTR

Individual provider Registered Dietetic Technician · NPI 1154264471

Miss. Crystal Jackson, NDTR is a Registered Dietetic Technician in Covington, Kentucky. Licensed in Ohio. Registered with an NPI since 2026.

Licensed in
OH
In the registry since
2026
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Practice location PO Box

The provider listed a PO Box rather than a street location, so this is not a walk-in address.

PO Box 12212
Covington, KY 41012-0212
Phone: (918) 732-9506
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietetic Technician (primary) Taxonomy 136A00000X · Licence 86047187 (OH)

Record details

NPI number1154264471
Entity typeIndividual (Type 1)
GenderFemale
Credentials NDTR
Sole proprietorNo
NPI enumeratedApril 11, 2026
Last updated in NPPESApril 11, 2026
Certification dateApril 11, 2026
Mailing addressPo Box 12212, Covington, KY 41012-0212