Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Janice Jackson, MD

Individual provider Pediatrics Physician · NPI 1902434780

Nicole Janice Jackson, MD is a Pediatrics Physician in Philadelphia, Pennsylvania. Works from 2 locations. Licensed in Indiana and Pennsylvania.

Licensed in
IN, PA
In the registry since
2020
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (800) 590-2160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 — (317) 948-2700

Specialties & licences

Pediatric Critical Care Medicine Physician (primary) Taxonomy 2080P0203X · Licence MD494588 (PA)
Pediatrics Physician Taxonomy 208000000X · Licence 01091554A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Pediatric Critical Care Medicine Physician Taxonomy 2080P0203X · Licence 11022739A (IN)

Record details

NPI number1902434780
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 29, 2020
Last updated in NPPESJune 7, 2026
Certification dateJune 7, 2026

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