Individual
JACKIE WESTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
24424 W MCNICHOLS RD, DETROIT, MI 48219-3653
(313) 255-0900
Mailing address
17421 TELEGRAPH RD, DETROIT, MI 48219-3165
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704279928
MI
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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