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

Nicole Jackson, RNCLINICALTHERAPIST

Individual provider Case Management Registered Nurse · NPI 1558256214

Nicole Jackson, RNCLINICALTHERAPIST is a Case Management Registered Nurse in Washington, District of Columbia. Practices as a sole proprietor. Licensed in District of Columbia.

Licensed in
DC
In the registry since
2025
Specialties on file
3

Practice location Address checks out

2124 Martin Luther King Jr Ave SE
Washington, DC 20020-5732
Phone: (817) 217-9825
Show map & directions

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

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 500020205 (DC)
Case Management Registered Nurse Taxonomy 163WC0400X · Licence 500020205 (DC)
Clinical Nurse Specialist Taxonomy 364S00000X · Licence 500020205 (DC)

Record details

NPI number1558256214
Entity typeIndividual (Type 1)
GenderFemale
Credentials RNCLINICALTHERAPIST
Sole proprietorYes
NPI enumeratedJune 11, 2025
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025

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