Individual
MR. CHRISTOPHER JOHN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
8921 HARVEY ST, LIVONIA, MI 48150-3518
(313) 815-6047
Mailing address
8921 HARVEY ST, LIVONIA, MI 48150-3518
(313) 815-6047
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704297208
MI
Other
Enumeration date
04/25/2019
Last updated
04/01/2021
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