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NPI Code Detail

MEDICARE: MARLAINA JACKSON

MEDICARE:   MARLAINA  JACKSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse212413OK

General Provider Information

NPI Number : 1205776010
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLAINA JACKSON
Provider Business Mailing Address
First Line : 14911 WUNDERLICH DR APT 1708
Second Line :
City : HOUSTON
State : TX
Zip : 77069-2046
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15150 BELLAIRE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77083-3100
Country : US
Telephone Number : 918-640-9871
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2026
Last Update Date : 03/31/2026

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Directions to “ MARLAINA JACKSON ” Practice Location

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