Catherine Brock Jackman, ACNS-BC

Primary specialty

Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X

License

4704135938 Issued in MI

Practice address

2799 W Grand Blvd
Detroit, MI 48202-2608

Phone

(313) 806-3269

NPI assigned

Mar 30, 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": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1689378804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 MAIN SAIL CT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482075008",
            "telephone_number": "313-806-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-806-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "CATHERINE",
        "middle_name": "BROCK",
        "name_prefix": "Ms.",
        "credential": "ACNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "MI",
            "license": "4704135938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lamis Jabri, M.D.
• Joseph Jabro, DO
• Lorelee Jacinto, P.T.
• Chaun Rene Jack
• Jackies Guardian Angels LLC.
• Latoya T Jackosn, COUNSELOR
• Mackenzie Jacks, PA-C
• Tameka Latoya Jackson -Dyer, IBCLC, CHW
• Phazhe Jackson Dorr
• Jackson Health Services

• Clinical Nurse Specialist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Nurse Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.