Individual provider · Type 1 NPI

Ruth A. Jackson, NP

Family Nurse Practitioner · Warren, MI

NPI number 1821731746 Active

Practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Fax (586) 573-5953

Mailing address

47650 Barbara Rd
Macomb, MI 48044-2410

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X4704330240 (MI)

Family Nurse Practitioner: Definition to come...

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About NPI 1821731746

Ruth A. Jackson, NP's National Provider Identifier is 1821731746, issued on Apr 18, 2022. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Warren, MI. The record was last updated on Apr 6, 2026.