Individual
MR. CHARLOTTE MARIE JACKSON-MELVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N. M.S.N.
Contact information
Practice address
6960 RIDGEWOOD RD, CLARKSTON, MI 48346-1031
(248) 625-7698
Mailing address
6960 RIDGEWOOD RD, CLARKSTON, MI 48346-1031
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704119146
MI
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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