TRACI LOUISE JACKSON


Address: 1628 19th St, Lubbock, TX 79401-4895
Phone: 8062190500

TRACI LOUISE JACKSON (NPI# 1366932931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366932931
Entity Type Individual
Full Name TRACI LOUISE JACKSON
Credential MS, RDN
Practice Address 1628 19th St
Lubbock
TX 79401-4895
Practice Telephone 8062190500
Mailing Telephone 8062190500
Mailing Fax Number 8067661286
Enumeration Date 2018-05-18
Last Update Date 2018-05-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133V00000X Dietitian, Registered DT85348 TX Dietary & Nutritional Service Providers

Other Providers TRACI JACKSON

NPI Name Taxonomy Address Enumeration
1821340498 Traci Jackson Licensed Practical Nurse 6462 Morris Rd, Munnsville, NY 13409-4122 2012-10-08
1164736278 Traci Brenee Jackson Counselor 300 E. Seminole, Seminole, OK 74858 2010-07-30
1689015778 Traci Ann Jackson Nurse Practitioner 3535 Olentangy River Rd, Columbus, OH 43214-3908 2013-07-17

Office Location

Street Address 1628 19TH ST
City LUBBOCK
State TX
Zip Code 79401-4895

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851365183 Tammy Artega Gilbert Counselor 1628 19th St, Lubbock, TX 79401-4832 2006-02-14
1689222077 Erin Stokes Marriage & Family Therapist 1628 19th St, Lubbock, TX 79401-4895 2019-08-28
1225696362 Heather Leigh Robertson Dietitian, Registered 1628 19th St, Lubbock, TX 79401 2019-06-04
1457810582 Kylee Brooke Stegall Occupational Therapist 1628 19th St, Lubbock, TX 79401-4832 2019-03-18
1144785221 Kelly Michelle Campbell Physical Therapist 1628 19th St, Lubbock, TX 79401-4895 2019-02-04
1003385170 Megan Nicol Wallace Speech-Language Pathologist 1628 19th St, Lubbock, TX 79401-4895 2018-11-19
1942778428 Taylor Marie Simmons Speech-Language Pathologist 1628 19th St, Lubbock, TX 79401-4832 2018-11-02
1316413263 Nicole Veronica Garcia Speech-Language Pathologist 1628 19th St, Lubbock, TX 79401-4895 2018-10-18
1164998035 Abigail Hart Harris Speech-Language Pathologist 1628 19th St, Lubbock, TX 79401-4895 2018-10-18
1700368636 Kortney Lynn Gholson Counselor 1628 19th St, Lubbock, TX 79401-4832 2018-09-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740688837 Cody Painter Student in an Organized Health Care Education/Training Program 43021 6th and Boston, Lubbock, TX 79401 2014-12-05
1730412511 Chiara Eberhardt Counselor 1614 Ave K, Lubbock, TX 79401 2009-09-11
1528265535 City of Lubbock Clinic/Center 80618th Street, Lubbock, TX 79401 2007-07-02
1184784084 Cc Home Health of Lubbock LLC Technician 2118 Broadway Ave, Lubbock, TX 79401 2006-12-11
1003997768 Charles Hudson Family Medicine Concord Medical Group, 1602 Avenue Q, Lubbock, TX 79401 2006-10-18
1003904376 Thi of Texas At Lubbock II, LLC Skilled Nursing Facility 1401 9th Street, Lubbock, TX 79401 2006-10-11
1174514681 United Supermarkets LLC Pharmacy 1610 5th St, Lubbock, TX 79401 2005-11-03
1669470332 Jose A Suarez Internal Medicine 1655 Main St Ste 201, Lubbock, TX 79401 2005-07-07
1801116314 Anju Varghese-thomas Dentist 2402 19th St, Lubbock, TX 79401 2010-06-07
1356460554 Community Health Center of Lubbock Inc. Clinic/Center 1610 5th St, Lubbock, TX 79401 2007-03-28
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Taxonomy Information

Taxonomy Code 133V00000X
Grouping Dietary & Nutritional Service Providers
Classification Dietitian, Registered

Taxonomy Definition

A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration.
Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265078372 Kaitlin Pharis Smith Dietitian, Registered 3004 50th St Ste A, Lubbock, TX 79413-4129 2019-11-24
1467095513 Sophia Maria Martinez Dietitian, Registered 6104 Avenue Q, Lubbock, TX 79412-3506 2019-10-22
1205331998 Lauren Blechle Dietitian, Registered 3615 19th St Bldg 17, Lubbock, TX 79410-1203 2018-03-26
1003357518 Emmy Lu Henley Dietitian, Registered 6520 University Ave, Suite 5, Lubbock, TX 79413 2017-03-16
1730635129 Katy Rebecca-franklin Poff Dietitian, Registered 7008 Indiana Avenue, Suite A, Lubbock, TX 79413 2016-08-26
1639531254 Lori Ann Boyd Dietitian, Registered 2412 50 Th Street, Lubbock, TX 79412 2016-03-23
1972918126 Premier Nutrition Consulting, LLC Dietitian, Registered 2907 Bates St, Lubbock, TX 79415-2646 2014-06-26
1790199248 Tiffany Ann Quevedo Dietitian, Registered 3008 55th St, Lubbock, TX 79413-4802 2014-06-12
1326486549 Amy Ashmore Dietitian, Registered 602 Indiana Ave # 5980, Lubbock, TX 79415-3364 2013-06-10
1952672578 Brooksgate Inc. Dietitian, Registered 6829 6th St, Lubbock, TX 79416-3769 2012-01-13
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Competitor

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City LUBBOCK
Zip Code 79401

Improve Information

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Dataset Information

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.

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