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MS. KEELY JACKSON CERTIFIED
NPI 1396044269
Specialist in Macomb, MI

Active since March 17, 2011
21268 VENICE DR, MACOMB, MI 48044(586) 948-8954(586) 948-8954 Get Directions Write a Review

NPPES record last updated: March 17, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Keely Jackson Certified NPPES

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

MS. KEELY JACKSON CERTIFIED (NPI 1396044269) is an individual specialist in Macomb, Michigan, licensed in Colorado (911223) and active in the NPI registry since March 2011.

NPPES Registry Identity

NPI1396044269
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameMS. KEELY JACKSONCredential: CERTIFIED
Location Address21268 VENICE DRMacomb, MI 48044-1315
Mailing Address21268 Venice DrMacomb, MI 48044-1315 · (586) 948-8954 · Fax (586) 948-8954
Phone(586) 948-8954
Fax(586) 948-8954
Sole ProprietorNo
Enumeration DateMarch 17, 2011
✔ NPI 1396044269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CO · 911223
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
21268 VENICE DR, Macomb, MI 48044
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Other Identifiers 1

Other208443128MI · Employer Identification Number

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 Keely Jackson's NPI number?

The NPI number for Keely Jackson is 1396044269. It was assigned to this individual provider in the NPPES registry on March 17, 2011.

Where is Keely Jackson located?

Keely Jackson practices at 21268 Venice Dr, Macomb, MI 48044. The listed phone number is (586) 948-8954.

What is Keely Jackson's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Keely Jackson was last updated on March 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.