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1114097870
EDNA RUTH JACKSON
DETROIT, MI
NPI
1114097870
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WA2000X Registered Nurse, Administrator
(Licence: MI 4704118498)
Enumeration Date
2006-11-09
Last Update Date
2007-07-08
Business Address
Mrs. EDNA RUTH JACKSON RN
2395 W GRAND BLVD
DETROIT, MI 48208-1210
Phone number: 313-897-2061
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Mailing Address
Mrs. EDNA RUTH JACKSON RN
18001 SAINT MARYS ST
DETROIT, MI 48235-3176
Phone number: 313-272-4034
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