National Provider Identifier Database

EDNA R JACKSON, RN – NPI #1114097870
Administrator


Contact Information

EDNA R JACKSON, RN
2395 W GRAND BLVD
DETROIT, MI48208-1210
Phone: 313-897-2061
Fax:
Website:
Specialty Taxonomy Code
* Administrator 163WA2000X

* Indicates primary specialty

NPI Profile & details for EDNA R JACKSON

NPI Number 1114097870
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 11/09/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 No
Identifiers
  • MI License #: 4704118498
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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