Individual
KRISHNA JAKKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(248) 522-7848
(248) 919-0791
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(248) 919-0791
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4704268080
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704268080
MI
Other
Enumeration date
05/26/2016
Last updated
05/07/2026
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