Active NPI
Milanj Elizabeth Jackson, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Middle River, MD
National Provider Identifier
1306590872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 28411
- Practice address
- 1330 Martin Blvd
Middle River, MD 21220-4104 - Phone
- (410) 406-9082
- NPI assigned
- Feb 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 28411 | MD | Primary |
Addresses
Primary practice location
1330 Martin Blvd
Middle River, MD 21220-4104
Mailing address
1330 Martin Blvd
Middle River, MD 21220-4104
Phone (410) 406-9082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28411 | MD | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643846400000",
"number": "1306590872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 MARTIN BLVD",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212204104",
"telephone_number": "410-406-9082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 MARTIN BLVD",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212204104",
"telephone_number": "410-406-9082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MILANJ",
"middle_name": "ELIZABETH",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-03",
"last_updated": "2022-02-03",
"certification_date": "2022-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MD",
"license": "28411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middle River, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.