Jacquil Jackson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704377769 Issued in MI

Practice address

3842 Cherry Creek LN
Sterling Heights, MI 48314-1035

Phone

(623) 349-2776

NPI assigned

Nov 6, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1255104766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3842 CHERRY CREEK LN",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3842 CHERRY CREEK LN",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141035",
            "telephone_number": "623-349-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JACQUIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704377769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Akram Jabboori, PHARMD
• Josephine Marie Jaboro
• Antoinette Marie Jackson
• Camryn Jackson
• Dominique Jackson, LCSW
• Jailyn Jackson
• Nariah Marie Jackson
• Raquel Jackson
• Tamika Jackson
• Jacob Kalo, M.D., P.C.

• Registered Nurse in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.