MRS. EDNA RUTH JACKSON RN NPI 1114097870

NPI Information

NPI: 1114097870
Provider Name: MRS. EDNA RUTH JACKSON, RN
Classification: Registered Nurse - 163WA2000X
Entity Type: Individual

Specialization: Administrator

Address:
2395 W GRAND BLVD
DETROIT, MI
ZIP 48208
Phone: (313) 897-2061
Get Directions

MRS. Edna Ruth Jackson, RN is an administrator registered nurse in Detroit, MI. MRS. Edna Ruth Jackson, RN NPI is 1114097870. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2395 W GRAND BLVD
DETROIT, MI
ZIP 48208-210
Phone: (313) 897-2061

The enumeration date for this NPI number is 11/9/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WA2000X	Registered Nurse	Administrator	4704118498	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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