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UTIVYA JACKSON RN
NPI 1013699453
Registered Nurse - General Practice in Detroit, MI

Active since August 04, 2023
4646 JOHN R ST, DETROIT, MI 48201(313) 576-1000 Get Directions Write a Review

NPPES record last updated: August 4, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Utivya Jackson Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UTIVYA JACKSON RN (NPI 1013699453) is an individual general practice provider in Detroit, Michigan, licensed in Michigan (4704267252) and active in the NPI registry since August 2023.

NPPES Registry Identity

NPI1013699453
Entity TypeIndividualFemale
Primary Taxonomy163WG0000X
Provider Legal NameUTIVYA JACKSONCredential: RN
Location Address4646 JOHN R STDetroit, MI 48201-1916
Mailing Address4646 John R StDetroit, MI 48201-1916 · (313) 576-1000
Phone(313) 576-1000
Sole ProprietorYes
Enumeration DateAugust 4, 2023
NPPES CertifiedAugust 4, 2023
✔ NPI 1013699453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · General PracticeNursing Service Providers
Taxonomy Code163WG0000X
License✔ Licensed in MI · 4704267252
4646 JOHN R ST, Detroit, MI 48201
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. YURIJ CHERSTYLO
Student in an Organized Health Care Education/Training Program
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
NAVITHA LONAPPAN
Registered Nurse (Medical-Surgical)
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
SHARI KABETH RN
Registered Nurse (Gastroenterology)
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
DEREK CURTIS THAMARUS
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1294
MOLLY GEORGE
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1316
EDWIN RAYMOND MILLER
Registered Nurse
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
MR. EDWIN INTIG LOON JR.
Licensed Practical Nurse
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000
ASHLEY NICOLE DANIELS MDIV
Religious Nonmedical Practitioner
4646 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Utivya Jackson's NPI number?

The NPI number for Utivya Jackson is 1013699453. It was assigned to this individual provider in the NPPES registry on August 4, 2023.

Where is Utivya Jackson located?

Utivya Jackson practices at 4646 John R St, Detroit, MI 48201. The listed phone number is (313) 576-1000.

What is Utivya Jackson's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in General Practice, with taxonomy code 163WG0000X.

When was this NPI record last updated?

The NPPES record for Utivya Jackson was last updated on August 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.