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NICHOLAS JACKSON
NPI 1023720802
Specialist in Moorhead, MN

Active since December 23, 2022
1505 30TH AVE S, MOORHEAD, MN 56560(218) 287-4338 Get Directions Write a Review

NPPES record last updated: December 23, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicholas Jackson NPPES

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

NICHOLAS JACKSON (NPI 1023720802) is an individual specialist in Moorhead, Minnesota and active in the NPI registry since December 2022.

NPPES Registry Identity

NPI1023720802
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameNICHOLAS JACKSON
Location Address1505 30TH AVE SMoorhead, MN 56560-5149
Mailing Address1547 30th Ave SMoorhead, MN 56560-5149
Phone(218) 287-4338
Sole ProprietorNo
Enumeration DateDecember 23, 2022
NPPES CertifiedDecember 23, 2022
✔ NPI 1023720802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1505 30TH AVE S, Moorhead, MN 56560
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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.

GRACIE SCHILLING
Specialist
1505 30TH AVE S
MOORHEAD, MN 56560
Clay County (218) 282-5299
AVERY MERSCHMAN
Specialist
1505 30TH AVE S
MOORHEAD, MN 56560
Clay County (218) 287-4338
EMILEE BEACK
Specialist
1505 30TH AVE S
MOORHEAD, MN 56560
Clay County (218) 287-4338
RYAN VANHOUSE
Specialist
1505 30TH AVE S
MOORHEAD, MN 56560
Clay County (218) 287-4338
CHRISTOPHER HANSON
Specialist
1505 30TH AVE S
MOORHEAD, MN 56560
Clay County (218) 287-4338
HODAN MOHOMED
Specialist
1505 30TH AVE S
MOORHEAD, MN 56560
Clay County (218) 287-4338
TETA DOE
Specialist
1505 30TH AVE S
MOORHEAD, MN 56560
Clay County (218) 287-4338
MOHAMED AHMED
Specialist
1505 30TH AVE S
MOORHEAD, MN 56560
Clay County (218) 287-4338

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 Nicholas Jackson's NPI number?

The NPI number for Nicholas Jackson is 1023720802. It was assigned to this individual provider in the NPPES registry on December 23, 2022.

Where is Nicholas Jackson located?

Nicholas Jackson practices at 1505 30th Ave S, Moorhead, MN 56560. The listed phone number is (218) 287-4338.

What is Nicholas Jackson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Nicholas Jackson was last updated on December 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.