Active NPI
Jacklyn Fleury, PHARMD
- Pediatric Pharmacist
- Detroit, MI
National Provider Identifier
1467262691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pharmacist
- License
- 5302416522
- Practice address
- 3901 Beaubien St
Detroit, MI 48201-2196 - Phone
- (313) 966-8510
- NPI assigned
- Jan 9, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pharmacist | 1835P0200X | 5302416522 | MI | Primary |
Addresses
Primary practice location
3901 Beaubien St
Detroit, MI 48201-2196
Mailing address
48425 Romeo Plank Rd
Macomb, MI 48044-2103
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302416522 | MI | MD | Pediatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736380800000",
"number": "1467262691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48425 ROMEO PLANK RD",
"city": "MACOMB",
"state": "MI",
"postal_code": "480442103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 BEAUBIEN ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012196",
"telephone_number": "313-966-8510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLEURY",
"first_name": "JACKLYN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-09",
"last_updated": "2025-01-09",
"certification_date": "2025-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pediatrics",
"state": "MI",
"license": "5302416522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.