Nicholas Jackson

NPI #1023720802 in Moorhead, Minnesota

Provider Information

NPI Number: 1023720802
Entity Type: Individual
Name: Nicholas Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Dec 23, 2022
Last Updated: Dec 23, 2022

Practice Location

Address: 1505 30TH AVE S
City: Moorhead
State: Minnesota
ZIP Code: 56560-5149
Phone: (218) 287-4338

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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