Individual
DEJUANA CHERISE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1051 N CANTON CENTER RD, CANTON, MI 48187-5097
(734) 998-2020
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704239536
MI
363LF0000X
Family Nurse Practitioner
Primary
4704239536
MI
Other
Enumeration date
10/31/2006
Last updated
10/30/2025
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