Individual
JENNIFER JABOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
43475 DALCOMA DR STE 100, CLINTON TWP, MI 48038-3593
(586) 263-5043
Mailing address
3601 W 13 MILE RD, 400 FSC - PCS, ROYAL OAK, MI 48073-6769
(248) 423-3144
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704165474
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430F364420
BCBSM
MI
05
—
4590068
—
MI
Enumeration date
03/21/2006
Last updated
02/07/2025
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