Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Keelan Raphael Jackson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790449882

Keelan Raphael Jackson is a Student in an Organized Health Care Education/Training Program in Parris Island, South Carolina. Licensed in South Carolina. Registered with an NPI since 2021.

Licensed in
SC
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Parris Island, SC

No coordinates on file. Search this address in Google Maps

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X · Licence 1790449882 (SC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790449882
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 26, 2021
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026

Other providers in Parris Island