Individual
JACQUELINE MACKENZIE JERNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
891 MARYLAND AVE NE, GRAND RAPIDS, MI 49505-6005
(616) 475-7577
(616) 301-2211
Mailing address
891 MARYLAND AVE NE, GRAND RAPIDS, MI 49505-6005
(616) 475-7577
(616) 301-2211
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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