Latoya Jackson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5214640 Issued in FL

Practice address

707 W 113TH Ave
Tampa, FL 33612-5617

Phone

(813) 638-2686

NPI assigned

Jul 31, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Latoya Etheridge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1785456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1902729601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W 113TH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W 113TH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125617",
            "telephone_number": "813-638-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LATOYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5214640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATOYA",
            "last_name": "ETHERIDGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenae Jackson
• Judith Jackson, ARNP
• Julie Jackson
• Julie Anna Jackson, BCABA
• Kesandra Jackson
• Leshandra Tiana Jackson
• Mark Jackson
• Mondrele Jackson
• Niaja Michelle Jackson, M.A.
• Rhonda Gary Jackson, ARNP

• Licensed Practical Nurse in Tampa, FL
• Providers in Tampa, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.