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

WILLOW LOTUS JACKSON RN
NPI 1396668588
Student in an Organized Health Care Education/Training Program in Orange, CT

Active since August 03, 2026
400 W CAMPUS DR, ORANGE, CT 06477(203) 785-6437 Get Directions Write a Review

NPPES record added: August 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Willow Lotus Jackson Rn NPPES

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

WILLOW LOTUS JACKSON RN (NPI 1396668588) is an individual student in an organized health care education/training program in Orange, Connecticut and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1396668588
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameWILLOW LOTUS JACKSONCredential: RN
Location Address400 W CAMPUS DROrange, CT 06477-3646
Mailing Address120 Nash StNew Haven, CT 06511-2644
Phone(203) 785-6437
Sole ProprietorNo
Enumeration DateAugust 3, 2026
NPPES CertifiedAugust 3, 2026
✔ NPI 1396668588 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
400 W CAMPUS DR, Orange, CT 06477
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLIVIA GLACKEN
Student in an Organized Health Care Education/Training Program
400 W CAMPUS DR
ORANGE, CT 06477
South Central Connecticut Planning Region (203) 785-6437
SAMANTHA JADE MOFFETT RN
Nurse Practitioner (Psychiatric/Mental Health)
400 W CAMPUS DR
ORANGE, CT 06477
South Central Connecticut Planning Region (203) 737-2357
KATHERINE SIEGEL APRN
Nurse Practitioner (Pediatrics)
400 W CAMPUS DR
ORANGE, CT 06477
South Central Connecticut Planning Region (203) 432-2700
SHELBY ROSE THOMASON RN
Student in an Organized Health Care Education/Training Program
400 W CAMPUS DR
ORANGE, CT 06477
South Central Connecticut Planning Region (203) 785-6437
MEGHAN YOUSO
Student in an Organized Health Care Education/Training Program
400 W CAMPUS DR
ORANGE, CT 06477
South Central Connecticut Planning Region (203) 785-2389
LEAH MATTIACCIO PMHNP-BC
Student in an Organized Health Care Education/Training Program
400 W CAMPUS DR
ORANGE, CT 06477
South Central Connecticut Planning Region (203) 785-2389
PEGGY WONG
Student in an Organized Health Care Education/Training Program
400 W CAMPUS DR
ORANGE, CT 06477
South Central Connecticut Planning Region (203) 432-2700
JENNIFER DEL CARMEN GONZALEZ-HOLMES
Nurse Practitioner
400 W CAMPUS DR
ORANGE, CT 06477
South Central Connecticut Planning Region (203) 785-2389

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 Willow Jackson's NPI number?

The NPI number for Willow Jackson is 1396668588. It was assigned to this individual provider in the NPPES registry on August 3, 2026.

Where is Willow Jackson located?

Willow Jackson practices at 400 W Campus Dr, Orange, CT 06477. The listed phone number is (203) 785-6437.

What is Willow Jackson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Willow Jackson was last updated on August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.