Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

DESIRAE JACKSON
NPI 1174436547
Technician, Pathology - Phlebotomy in Glendale, AZ

Q: What is Desirae Jackson's NPI number?

The NPI number for Desirae Jackson is 1174436547. It was assigned to this individual provider in the NPPES registry on September 25, 2026.

Q: What is Desirae Jackson's specialty?

The primary specialty registered for this NPI is Technician, Pathology, specializing in Phlebotomy, with taxonomy code 246RP1900X.

Q: When was this NPI record last updated?

The NPPES record for Desirae Jackson was last updated on September 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 25, 2026

6856 W MARYLAND AVE UNIT 5111, GLENDALE, AZ 85303(480) 266-0314 Get Directions Write a Review

NPPES record added: September 25, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

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About Desirae Jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DESIRAE JACKSON (NPI 1174436547) is an individual phlebotomy provider in Glendale, Arizona and active in the NPI registry since September 2026.

NPPES Registry Identity

NPI1174436547

Entity TypeIndividualFemale

Primary Taxonomy246RP1900X

Provider Legal NameDESIRAE JACKSON

Location Address6856 W MARYLAND AVE UNIT 5111Glendale, AZ 85303-0043

Mailing Address6856 W Maryland Ave Unit 5111Glendale, AZ 85303-0043 · (480) 266-0314

Phone(480) 266-0314

Sole ProprietorYes

Enumeration DateSeptember 25, 2026

NPPES CertifiedSeptember 25, 2026

✔ NPI 1174436547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician, Pathology · PhlebotomyTechnologists, Technicians & Other Technical Service Providers

Taxonomy Code246RP1900X

6856 W MARYLAND AVE UNIT 5111, Glendale, AZ 85303

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Desirae Jackson's NPI number?

The NPI number for Desirae Jackson is 1174436547. It was assigned to this individual provider in the NPPES registry on September 25, 2026.

Where is Desirae Jackson located?

Desirae Jackson practices at 6856 W Maryland Ave Unit 5111, Glendale, AZ 85303. The listed phone number is (480) 266-0314.

What is Desirae Jackson's specialty?

The primary specialty registered for this NPI is Technician, Pathology, specializing in Phlebotomy, with taxonomy code 246RP1900X.

When was this NPI record last updated?

The NPPES record for Desirae Jackson was last updated on September 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.