Individual provider · Type 1 NPI
Jessica Logan, RN, NP
Adult Health Nurse Practitioner · Dearborn, MI
NPI number
1043040975
Active
Practice location
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 4704330120 (MI) |
| Critical Care Medicine Registered Nurse | 163WC0200X | 4704330120 (MI) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1043040975
Jessica Logan, RN, NP's National Provider Identifier is 1043040975, issued on Aug 5, 2024. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Dearborn, MI. The record was last updated on Jan 30, 2026.