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

Miss. Crystal Jackson, NDTR

Individual provider Registered Dietetic Technician · NPI 1154264471

Miss. Crystal Jackson, NDTR is a Registered Dietetic Technician in Covington, Kentucky. Licensed in Ohio. Registered with an NPI since 2026.

Licensed in
OH
In the registry since
2026
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Practice location PO Box

The provider listed a PO Box rather than a street location, so this is not a walk-in address.

PO Box 12212
Covington, KY 41012-0212
Phone: (918) 732-9506
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietetic Technician (primary) Taxonomy 136A00000X · Licence 86047187 (OH)

Record details

NPI number1154264471
Entity typeIndividual (Type 1)
GenderFemale
Credentials NDTR
Sole proprietorNo
NPI enumeratedApril 11, 2026
Last updated in NPPESApril 11, 2026
Certification dateApril 11, 2026