ANDRIA JACKSON (NPI# 1073138285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073138285 |
Entity Type | Individual |
Full Name | ANDRIA JACKSON |
Practice Address |
9560 Marlboro Pike Ste 105 Upper Marlboro MD 20772-3770 |
Practice Telephone | 3015357542 |
Mailing Telephone | 3015357542 |
Enumeration Date | 2020-06-12 |
Last Update Date | 2020-06-12 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
407120 | MD | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | COSMETOLOGY LICENCE | 407120 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053851063 | Andria Daniell Jackson | Counselor | 4859 Shed Rd Suite 200, Bossier, LA 71111 | 2017-02-24 |
Street Address |
9560 MARLBORO PIKE STE 105 |
City | UPPER MARLBORO |
State | MD |
Zip Code | 20772-3770 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255956181 | Natural Touch Hair Studio Inc | Case Management | 9560 Marlboro Pike Ste 105, Upper Marlboro, MD 20772-3770 | 2020-06-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497355077 | Doris Lynn Perkins | Pharmacist | 5700 Southeast Crain Hwy, Upper Marlboro, MD 20772 | 2020-10-31 |
1730790221 | Creative Mind Therapy | Community/Behavioral Health | 12419 Dorsey Ln, Upper Marlboro, MD 20772 | 2020-08-10 |
1932727369 | Shaquitta Morton | Behavior Technician | 9440 Marlboro Pike 100, Upper Marlboro, MD 20772 | 2020-07-13 |
1760022958 | Keri Daniel | Nurse Practitioner | 9723 Frank Tippett Rd, Upper Marlboro, MD 20772 | 2020-01-15 |
1932668134 | Dentistry for Children of Maryland, LLC | Clinic/Center | 9616 Marlboro Pike, Upper Marlboro, MD 20772 | 2019-03-18 |
1033673918 | Shonte Renee Drakeford | Nurse Practitioner | 6610 Woodyard Road, Upper Marlboro, MD 20772 | 2019-01-25 |
1902391261 | Myenne Hanson | Home Health Aide | 5002 Ashford Dr, Upper Marlboro, MD 20772 | 2018-06-28 |
1659884849 | Clement Okehie | Home Health Aide | 13939 Bishops Bequest Rd, Upper Marlboro, MD 20772 | 2017-11-09 |
1497264766 | Fatu Barrie | Technician | 11112 Cranfod Drive, Upper Marlboro, MD 20772 | 2017-09-29 |
1801315080 | Hope Academy & Nursing Services | Nursing Care | 14101 Christian Street, Upper Marlboro, MD 20772 | 2017-09-19 |
Find all providers in zip 20772 |
Taxonomy Code | 1744P3200X |
Grouping | Other Service Providers |
Classification | Specialist |
Specialization | Prosthetics Case Management |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538723267 | Katoya Nicole Shaw | Specialist | 12544 Woodstock Dr E, Upper Marlboro, MD 20772-5131 | 2019-04-29 |
1770055865 | Aja Shanae Nelson | Specialist | 9525 Westerdale Dr, Upper Marlboro, MD 20774-2440 | 2018-12-30 |
1962942011 | Jennifer Winston | Specialist | 22 Herrington Dr, Upper Marlboro, MD 20774-1506 | 2017-03-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477153633 | Katreia Chareece White | Specialist | 5612 Saint Barnabas Rd, Oxon Hill, MD 20745-3626 | 2020-10-27 |
1437766482 | Natalyn Obey | Specialist | 10095 Washington Blvd N Ste 134, Laurel, MD 20723-1968 | 2020-09-24 |
1013528686 | Melissa Hammond | Specialist | 595 Main St Ste 235a, Laurel, MD 20707-4352 | 2020-08-16 |
1497373492 | Irene Marie Watkins | Specialist | 595 Main St Ste 235, Laurel, MD 20707-4352 | 2020-07-07 |
1467074849 | Martha Tanesha Hines | Specialist | 3407 Fort Meade Rd Ste 14, Laurel, MD 20724-2003 | 2020-05-08 |
1215558473 | Teraga Gross | Specialist | 5201 Ivanhoe Ave, Baltimore, MD 21212-4322 | 2020-04-29 |
1275168312 | Barry Staten | Specialist | 2323 Shadyside Ave, Suitland, MD 20746-4827 | 2020-03-09 |
1609401066 | Demarcus Tyler | Specialist | 5526 Belair Rd, Baltimore, MD 21206-3614 | 2020-03-05 |
1790316206 | Antjuan Mandwell Bunn | Specialist | 8147 Baltimore Ave Ste C, College Park, MD 20740-2492 | 2020-02-03 |
1912538976 | Latreshia Shanae Maximo- Bowman | Specialist | 5441 Baltimore National Pike Ste 2a, Baltimore, MD 21229-2102 | 2020-01-29 |
Find all providers with the same taxonomy |
City | UPPER MARLBORO |
Zip Code | 20772 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.