NPI 1154264471

Crystal Jackson, NDTR

Practitioner Registered Dietetic Technician Covington, KY

Practice location

Address: PO Box 12212, Covington, KY 41012-0212
Phone: (918) 732-9506

Registered specialties

Registered Dietetic Technician Primary

Dietary & Nutritional Service Providers Taxonomy 136A00000X Licence 86047187 (OH)

Other Dietetic Technician, Registered providers in Kentucky →

Registry record

NPI: 1154264471
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Apr 2026
Record last updated: 11 Apr 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.