Individual provider · Type 1 NPI

Nicole Janice Jackson, MD

Pediatric Critical Care Medicine Physician · Philadelphia, PA

NPI number 1902434780 Active

Practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Call (800) 590-2160 Map

Mailing address

PO Box 778912
Chicago, IL 60677-8912

Other practice locations

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

Specialties and licenses

TaxonomyCodeLicense
Pediatrics Physician 208000000X01091554A (IN)
Pediatric Critical Care Medicine Physician Primary 2080P0203XMD494588 (PA)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Pediatric Critical Care Medicine Physician 2080P0203X11022739A (IN)

Pediatric Critical Care Medicine Physician: A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates…

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About NPI 1902434780

Nicole Janice Jackson, MD's National Provider Identifier is 1902434780, issued on Mar 29, 2020. The primary taxonomy on file is Pediatric Critical Care Medicine Physician (2080P0203X), and the practice location is in Philadelphia, PA. The record was last updated on Jun 7, 2026.