Jennifer Ekundayo Jackson-Bickersteth, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP42512 Issued in MD

Practice address

6040 Southport Dr
Bethesda, MD 20814-1848

Phone

(301) 715-3673

Fax

(888) 496-8354

NPI assigned

Oct 24, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1093432809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 MARSDEN CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217036858",
            "telephone_number": "240-604-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 SOUTHPORT DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141848",
            "telephone_number": "301-715-3673",
            "fax_number": "888-496-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-BICKERSTETH",
        "first_name": "JENNIFER",
        "middle_name": "EKUNDAYO",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MD",
            "license": "LP42512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shruti Iyer, DO
• Arthur Dean Jabs Jr., M.D, PH.D
• Benjamin Jack, DO
• Jane Elaine Jacknewitz-Woolard, RN, DNP, CS, P/FNP
• Ebony Jackson Clark, PT, DPT
• Anita Estell Jackson
• Antoine Jackson, MSW
• Ashley Jackson, DMD
• Ashley Young Jackson, M.D.
• Bria Shar-Ren Jackson

• Licensed Practical Nurse in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Licensed Practical Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.