Individual
FAYE YVETTE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
245 PITKIN ST, HIGHLAND PARK, MI 48203-3737
(313) 867-1500
Mailing address
15193 HALLER ST, LIVONIA, MI 48154-4017
(313) 377-8844
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704245163
MI
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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