Individual
BEVERLY JOYCE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-3349
Mailing address
20510 FAUST AVE, DETROIT, MI 48219-1551
(313) 605-8611
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704130066
MI
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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