# ANDREA M. JACKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1528179215
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 0101039547 | VA | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | 25MA11775800 | NJ | — |
| 207V00000X | Obstetrics & Gynecology Physician | 95446 | GA | — |
| 207V00000X | Obstetrics & Gynecology Physician | C1-0025384 | DE | — |
| 207V00000X | Obstetrics & Gynecology Physician | D0080571 | MD | — |
| 207V00000X | Obstetrics & Gynecology Physician | ME161053 | FL | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 04/09/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1528179215 | — | VA |