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

Mr. Jesse Jose Jackson

Individual provider Registered Dietitian · NPI 1306763933

Mr. Jesse Jose Jackson is a Registered Dietitian in Columbia, Missouri. Licensed in Missouri. Registered with an NPI since 2026.

Licensed in
MO
In the registry since
2026

Practice location Address checks out

2005 Parkade Blvd
Columbia, MO 65202-3122
Phone: (573) 825-3695
Show map & directions

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

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 86466453 (MO)

Record details

NPI number1306763933
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 3, 2026
Last updated in NPPESJuly 3, 2026
Certification dateJuly 3, 2026
Mailing address2005 Parkade Blvd, Columbia, MO 65202-3122

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