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1013699453
UTIVYA JACKSON
DETROIT, MI
NPI
1013699453
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WG0000X Registered Nurse, General Practice
(Licence: MI 4704267252)
Enumeration Date
2023-08-04
Last Update Date
2023-08-04
Business Address
UTIVYA JACKSON RN
4646 JOHN R ST
DETROIT, MI 48201-1916
Phone number: 313-576-1000
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Mailing Address
UTIVYA JACKSON RN
4646 JOHN R ST
DETROIT, MI 48201-1916
Phone number: 313-576-1000
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