Evelyn Jackson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704138318 Issued in MI

Practice address

5898 Augusta LN
Grand Blanc, MI 48439-9472

Phone

(734) 241-3891

Fax

(734) 241-0014

NPI assigned

Jan 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• American Anesthesiology Associates of Michigan, PC

  • Anesthesiology Physician
  • Grand Blanc, MI
  • NPI 1235181223

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457330821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 E DUNBAR RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619127",
            "telephone_number": "734-241-3891",
            "fax_number": "734-241-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5898 AUGUSTA LN",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484399472",
            "telephone_number": "734-241-3891",
            "fax_number": "734-241-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EVELYN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704138318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "4308751540",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Jaboro
• Jackson Chiropractic Clinic, PC
• Avery Michael Jackson III, M.D.
• Caramarie Jackson, PA-C
• Charles Arthur Jackson Jr., D.C.
• Givaunni S Jackson
• Erica Jacob, CCC-SLP
• Logan Thomas Jacobs, DO
• Matthew D Jacobs
• Tina Jaeger, MA, LLPC

• Certified Registered Nurse Anesthetist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.