IndividualActive
Andria Jackson
NPI 1073138285 · Prosthetics Case Management · Upper Marlboro, MD
Provider details
- NPI number
- 1073138285
- Entity type
- Individual
- Primary specialty
- Prosthetics Case ManagementOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 407120 (MD)
Specialties & taxonomies
Other Service Providers
Practice location
9560 Marlboro Pike Ste 105
Upper Marlboro, MD 20772-3770
Phone: (301) 535-7542
Approximate (ZIP-level) locationGet directions
Mailing address
9560 Marlboro Pike Ste 105
Upper Marlboro, MD 20772-3770
Registry dates
- Enumerated
- 2020-06-12
- Last updated
- 2020-06-12
- Certified
- 2020-06-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.