Individual provider · Type 1 NPI

Pharrodah Jackson, LPN

Licensed Practical Nurse · Annandale, VA

NPI number 1154201663 Active

Practice location

7008 Little River Tpke Ste G
Annandale, VA 22003-3234

Mailing address

5113 Southern Ave Apt 101
Capitol Heights, MD 20743-5170

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X0002098056 (VA)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1154201663

Pharrodah Jackson, LPN's National Provider Identifier is 1154201663, issued on Sep 4, 2025. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Annandale, VA. The record was last updated on Sep 4, 2025.