Individual
ARCHIA DENISE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
3075 ORCHARD VISTA DR SE, GRAND RAPIDS, MI 49546-7069
(989) 493-1964
Mailing address
5593 CORYDALIS DR, SAGINAW, MI 48603-1685
(989) 493-1964
(989) 493-1964
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704235782
MI
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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