Organization
NISHA JACKSON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARISSA STULTS (VP OF BILLING AND CONTRACTING)
(541) 930-8545
Entity
Organization
Contact information
Practice address
3265 HILLCREST PARK DR, MEDFORD, OR 97504-7657
(541) 494-9355
(541) 210-8724
Mailing address
3265 HILLCREST PARK DR, MEDFORD, OR 97504-7657
(541) 494-9355
(541) 494-0945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
086006299N7
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012158
—
OR
Enumeration date
10/15/2015
Last updated
07/31/2026
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