Debbie Cherrie Jackson, RD

Individual provider Active NPI Registered Dietitian · Marcellus, MI

NPI 1184496952 · NPPES record last updated Oct 25, 2023

Key facts

NPI
1184496952
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
890322 (MI)
Practice address
11096 Cranberry St
Marcellus, MI 49067-9484
Phone
(269) 718-8704
NPI assigned
Oct 25, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
890322MIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 890322 MI Yes

Addresses

Primary practice location

11096 Cranberry St
Marcellus, MI 49067-9484

Mailing address

11096 Cranberry St
Marcellus, MI 49067-9484
Phone (269) 718-8704

Other providers in Marcellus, MI

All providers in Marcellus, MI · Registered Dietitian in Michigan

Sources for this page

Verify at the official NPI Registry.