Ebony Jackson

Case Manager/Care Coordinator · Upper Marlboro, MD

Individual Active NPI

NPI number 1134093628

Practice location

7311 Loanda Dr
Upper Marlboro, MD 20772-4274
Phone
(202) 985-9995

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NPI record

NPI
1134093628
Entity type
Individual (Type 1)
Enumeration date
September 30, 2025
Last updated
September 30, 2025
Certified
September 30, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Case Manager/Care Coordinator Primary 171M00000X 2299105 DC

Mailing address

239 57TH Pl NE
Washington, DC 20019-6866
Phone
(310) 895-6008

About Ebony Jackson

Ebony Jackson is a healthcare provider registered in the NPI registry with the primary taxonomy Case Manager/Care Coordinator (code 171M00000X). The practice location is 7311 Loanda Dr, Upper Marlboro, MD 20772-4274. The NPI number 1134093628 was assigned on September 30, 2025 and the record was last updated on September 30, 2025.

Ebony Jackson lists a license in the registry: #2299105 (DC) for Case Manager/Care Coordinator. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ebony Jackson?

The NPI number is 1134093628.

What is the phone number of Ebony Jackson?

The phone number listed for the practice location is (202) 985-9995.

Where is Ebony Jackson located?

7311 Loanda Dr, Upper Marlboro, MD 20772-4274.

What is the taxonomy code for Ebony Jackson?

The primary taxonomy code is 171M00000X – Case Manager/Care Coordinator.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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