Jackson, Diana

Jackson, Diana is an individual health care provider with primary practice located at 6628 Crescent Grn , West Bloomfield MI 48322-1325. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Jackson, Diana can be contacted via phone (248) 592-9803.

Contact Information

Primary practice address
6628 Crescent Grn West Bloomfield MI 48322-1325
Phone: (248) 592-9803
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 4703092206 Michigan

Profile Details

NPI number 1962631424
LBN Legal business name Jackson, Diana
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2009
Last updated Jul 6th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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