Lechel Jackson
Individual provider Active NPI Registered Nurse · Harrison Township, MI
NPI 1164920153 · NPPES record last updated Jan 25, 2018
Key facts
- NPI
- 1164920153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 4704296540 (MI)
- Practice address
- 35040 Renfrew St
Harrison Township, MI 48045-3605 - Phone
- (313) 737-9195
- NPI assigned
- Jan 25, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704296540 | MI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704296540 | MI | Yes |
Addresses
Primary practice location
35040 Renfrew St
Harrison Township, MI 48045-3605
Mailing address
35040 Renfrew St
Harrison Township, MI 48045-3605
Other providers in Harrison Township, MI
- Wafaa Hanna
- Henry Ford Health St. John Hospital
- Shakemma Holloway
- Janet Nicole Humphrey
- Integrated Solution LLC
- Mary Ann Jackson
- Kennieth Rosean Jones
- Kassi Shania Jordan
- Kanwaljit Kaur
- Jennifer Kirkpatrick
All providers in Harrison Township, MI · Registered Nurse in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.