Individual provider · Type 1 NPI
Edna Ruth Jackson, RN
Administrator Registered Nurse · Detroit, MI
NPI number
1114097870
Active
Practice location
2395 W Grand Blvd
Detroit, MI 48208-1210
Mailing address
18001 Saint Marys St
Detroit, MI 48235-3176
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Administrator Registered Nurse Primary | 163WA2000X | 4704118498 (MI) |
Administrator Registered Nurse: Definition to come...
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- Charmaine Munn Hudson, NPFamily Nurse Practitioner Detroit, MI NPI 1780307082
- David Alton Aprahamian, DOFamily Medicine Physician Detroit, MI NPI 1043369929
- Lisa Marie Randon, MDPediatrics Physician Detroit, MI NPI 1316088644
- Stanley Keith Frencher Sr., MDInternal Medicine Physician Detroit, MI NPI 1659468379
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About NPI 1114097870
Edna Ruth Jackson, RN's National Provider Identifier is 1114097870, issued on Nov 9, 2006. The primary taxonomy on file is Administrator Registered Nurse (163WA2000X), and the practice location is in Detroit, MI. The record was last updated on Jul 8, 2007.