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JACKSON LAWRENCE LISOTTA SRNA
NPI 1831043330
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since February 23, 2026
525 VINE ST, WINSTON SALEM, NC 27101(336) 716-1411 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jackson Lawrence Lisotta Srna NPPES

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

JACKSON LAWRENCE LISOTTA SRNA (NPI 1831043330) is an individual student in an organized health care education/training program in Winston Salem, North Carolina, licensed in North Carolina (365263) and active in the NPI registry since February 2026.

NPPES Registry Identity

NPI1831043330
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACKSON LAWRENCE LISOTTACredential: SRNA
Location Address525 VINE STWinston Salem, NC 27101-4125
Mailing Address525 Vine StWinston Salem, NC 27101-4125 · (336) 716-1411
Phone(336) 716-1411
Sole ProprietorNo
Enumeration DateFebruary 23, 2026
NPPES CertifiedFebruary 23, 2026
✔ NPI 1831043330 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
License✔ Licensed in NC · 365263
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.

525 VINE ST, Winston Salem, NC 27101
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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.

ALEXA KASS
Nurse Anesthetist, Certified Registered
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
MRS. ALEXANDRA RHEA FLOWE ISLEY DNP, CRNA
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
SYDNEY TRANSOU STIEFEL CRNA, DNP
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
LINDSEY SEVERUD
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
SAMUEL PARKER CONNELL
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
MADELINE GRINER
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
LUCY HERNANDEZ
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
ERIN RIDDLE SRNA
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411

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 Jackson Lisotta's NPI number?

The NPI number for Jackson Lisotta is 1831043330. It was assigned to this individual provider in the NPPES registry on February 23, 2026.

Where is Jackson Lisotta located?

Jackson Lisotta practices at 525 Vine St, Winston Salem, NC 27101. The listed phone number is (336) 716-1411.

What is Jackson Lisotta'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 Jackson Lisotta was last updated on February 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.