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Organization
ADMIRAL MEDICAL MANAGEMENT GROUP LLC
Active
Organization
ADMIRAL MEDICAL MANAGEMENT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KETURA JACKSON APRN CNP (APRN CNP)
(216) 855-7775
Entity
Organization
Contact information
Practice address
11201 SHAKER BLVD UNIT 201, CLEVELAND, OH 44104-3869
(216) 855-7775
Mailing address
11201 SHAKER BLVD UNIT 201, CLEVELAND, OH 44104-3869
(216) 855-7775
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
366986
OH
261Q00000X
Clinic/Center
—
OH
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
OH
261QP2300X
Primary Care Clinic/Center
—
OH
Other
Enumeration date
02/22/2018
Last updated
09/17/2024
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