Individual
RUSSCHEL JANE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-2800
Mailing address
11311 GRAYFIELD, REDFORD, MI 48239-1451
(313) 303-1124
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13550
MO
163WC0200X
Critical Care Medicine Registered Nurse
Primary
4704203865
MI
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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