MRS. EDNA RUTH JACKSON RN
NPI 1114097870
Registered Nurse - Administrator in Detroit, MI

Active since November 09, 2006
2395 W GRAND BLVD, DETROIT, MI 48208(313) 897-2061 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Edna Ruth Jackson Rn NPPES

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

MRS. EDNA RUTH JACKSON RN (NPI 1114097870) is an individual administrator provider in Detroit, Michigan, licensed in Michigan (4704118498) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1114097870
Entity TypeIndividualFemale
Primary Taxonomy163WA2000X
Provider Legal NameMRS. EDNA RUTH JACKSONCredential: RN
Location Address2395 W GRAND BLVDDetroit, MI 48208-1210
Mailing Address18001 Saint Marys StDetroit, MI 48235-3176 · (313) 272-4034
Sole ProprietorNo
Enumeration DateNovember 9, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1114097870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRegistered Nurse · AdministratorNursing Service Providers
Taxonomy Code163WA2000X
License Licensed in MI · 4704118498
2395 W GRAND BLVD, Detroit, MI 48208

Other Providers at the Same Location NPPES 8

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

Internal Medicine
2395 W GRAND BLVD
DETROIT, MI 48208
Family Medicine
2395 W GRAND BLVD
DETROIT, MI 48208
Advanced Practice Midwife
2395 W GRAND BLVD
DETROIT, MI 48208
Pediatrics
2395 W GRAND BLVD
DETROIT, MI 48208
Internal Medicine
2395 W GRAND BLVD
DETROIT, MI 48208
Nurse Practitioner (Family)
2395 W GRAND BLVD
DETROIT, MI 48208
Nurse Practitioner (Adult Health)
2395 W GRAND BLVD
DETROIT, MI 48208
Legal Medicine
2395 W GRAND BLVD
DETROIT, MI 48208

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 Edna Jackson's NPI number?

The NPI number for Edna Jackson is 1114097870. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Where is Edna Jackson located?

Edna Jackson practices at 2395 W Grand Blvd, Detroit, MI 48208. The listed phone number is (313) 897-2061.

What is Edna Jackson's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Administrator, with taxonomy code 163WA2000X.

When was this NPI record last updated?

The NPPES record for Edna Jackson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.