Krystle Starr Marie Jackson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

28208846A Issued in IN

Practice address

8701 Broadway
Merrillville, IN 46410-7035

Phone

(219) 738-5510

NPI assigned

Feb 27, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1417754292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5433 VAN BUREN ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464101460",
            "telephone_number": "765-461-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107035",
            "telephone_number": "219-738-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRYSTLE",
        "middle_name": "STARR MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28208846A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J.K.Kansal MD PC
• Priasha Jachna, MED, BCBA
• Sha-Ron Jackson-Johnson, MD
• Danielle Jackson, APRN
• Felicia Jackson
• Marshanna Jackson, RBT
• Roger Dale Jackson, MA
• Zohra Jackson
• Brent Jacobus II, MD
• Hayder Jaffer, MD

• Registered Nurse in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.