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Individual

BRYANNA JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17200 E 10 MILE RD, EASTPOINTE, MI 48021-3355
(313) 324-2144
Mailing address
17200 E 10 MILE RD, EASTPOINTE, MI 48021-3355
(313) 324-2144

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703127352
MI

Other

Enumeration date
04/03/2023
Last updated
04/03/2023
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