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MRS. ILLEANA ELIZABETH JACKSON LMT/MLD
NPI 1790636777
Massage Therapist in Fayetteville, NC

Active since February 05, 2026
6682 VAUGHN RD, FAYETTEVILLE, NC 28304(910) 885-5396 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mrs. Illeana Elizabeth Jackson Lmt/mld NPPES

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

MRS. ILLEANA ELIZABETH JACKSON LMT/MLD (NPI 1790636777) is an individual massage therapist in Fayetteville, North Carolina, licensed in North Carolina (17654) and active in the NPI registry since February 2026.

NPPES Registry Identity

NPI1790636777
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameMRS. ILLEANA ELIZABETH JACKSONCredential: LMT/MLD
Location Address6682 VAUGHN RDFayetteville, NC 28304-6009
Mailing Address6682 Vaughn RdFayetteville, NC 28304-6009 · (910) 885-5396
Phone(910) 885-5396
Sole ProprietorYes
Enumeration DateFebruary 5, 2026
NPPES CertifiedFebruary 5, 2026
✔ NPI 1790636777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in NC · 17654
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
6682 VAUGHN RD, Fayetteville, NC 28304
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 Illeana Jackson's NPI number?

The NPI number for Illeana Jackson is 1790636777. It was assigned to this individual provider in the NPPES registry on February 5, 2026.

Where is Illeana Jackson located?

Illeana Jackson practices at 6682 Vaughn Rd, Fayetteville, NC 28304. The listed phone number is (910) 885-5396.

What is Illeana Jackson's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Illeana Jackson was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.