Individual
RASHAWN MICHAEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1500 EUREKA RD, WYANDOTTE, MI 48192-6103
(734) 282-2500
(734) 282-6397
Mailing address
24900 MYLER ST, TAYLOR, MI 48180-2187
(734) 635-5685
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704409049
MI
363LF0000X
Family Nurse Practitioner
RN297974
GA
Other
Enumeration date
02/19/2022
Last updated
02/08/2024
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