Individual provider · Type 1 NPI

Demetrius Emmanuel Jackson

Pediatric Registered Nurse · Madison, WI

NPI number 1922902287 Active

Practice location

701 Highland Ave
Madison, WI 53705-2202

Specialties and licenses

TaxonomyCodeLicense
Pediatric Registered Nurse Primary 163WP0200X1102063-30 (WI)

Pediatric Registered Nurse: Definition to come...

11 other providers at this address

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About NPI 1922902287

Demetrius Emmanuel Jackson's National Provider Identifier is 1922902287, issued on Oct 7, 2026. The primary taxonomy on file is Pediatric Registered Nurse (163WP0200X), and the practice location is in Madison, WI. The record was last updated on Oct 21, 2026.