Individual
HEATHER ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
6286 PEPPER HILL ST, WEST BLOOMFIELD, MI 48322-2301
(313) 400-8007
Mailing address
6286 PEPPER HILL ST, WEST BLOOMFIELD, MI 48322-2301
(313) 400-8007
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704214316
MI
363LA2100X
Acute Care Nurse Practitioner
4704214316
MI
Other
Enumeration date
08/08/2013
Last updated
07/06/2023
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