Individual provider · Type 1 NPI
Crystal Jackson, NDTR
Registered Dietetic Technician · Covington, KY
Practice location
PO Box 12212
Covington, KY 41012-0212
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Dietetic Technician Primary | 136A00000X | 86047187 (OH) |
Registered Dietetic Technician: A Dietetic Technician, Registered (DTR)/Nutrition and Dietetics Technician, Registered (NDTR) is an individual holding a nationally protected title issued by the Commission on Dietetic Registration (CDR) to qualified individuals who obtain an associate's degree or higher and successfully complete a sliding set of academic, examination, and practice requirements accredited by the Accreditation Council for Education i…
About NPI 1154264471
Crystal Jackson, NDTR's National Provider Identifier is 1154264471, issued on Apr 11, 2026. The primary taxonomy on file is Registered Dietetic Technician (136A00000X), and the practice location is in Covington, KY. The record was last updated on Apr 11, 2026.