Individual
MRS. JOY LYNETTE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
19193 MANSFIELD ST, DETROIT, MI 48235-2316
(313) 272-1052
(313) 272-2289
Mailing address
19193 MANSFIELD ST, DETROIT, MI 48235-2316
(313) 272-1052
(313) 272-2289
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703077724
MI
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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