Individual
MS. JACQUETTE WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
36741 NANTUCKET CT, CLINTON TWP, MI 48035-1165
(586) 265-6776
Mailing address
36741 NANTUCKET CT, CLINTON TWP, MI 48035-1165
(586) 265-6776
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703120437
MI
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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