Jackson, Nisha Marie

Jackson, Nisha Marie is an individual health care provider with primary practice located at 3156 State St , Medford OR 97504-8450. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Jackson, Nisha Marie can be contacted via phone (541) 773-9772.

Contact Information

Primary practice address
3156 State St Medford OR 97504-8450
Phone: (541) 773-9772
Fax: (541) 773-1113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 86006299 Oregon

Profile Details

NPI number 1952326266
LBN Legal business name Jackson, Nisha Marie
Credentials MS, WHCNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Mar 7th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952326266 NPPES
Oregon MEDICAID 012158

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