Individual
TACARRA JERNAGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21509 FENKELL ST, DETROIT, MI 48223-1512
(734) 460-5100
Mailing address
2315 STEEPLECHASE RD, CANTON, MI 48188-0026
(124) 867-8797
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
4704340544
MI
251E00000X
Home Health Agency
—
—
364S00000X
Clinical Nurse Specialist
4704340544
MI
Other
Enumeration date
12/26/2023
Last updated
12/26/2023
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