NPI 1386101574

Yamisha Jackson, CNA

Practitioner Adult Companion Detroit, MI

Practice location

Address: 11611 Grayton St, Detroit, MI 48224-1643
Phone: (313) 556-4769
Fax: (313) 473-8192
Mailing address: 7762 Rosemont Ave, Detroit, MI 48228-5426

Registered specialties

Adult Companion Primary

Nursing Service Related Providers Taxonomy 372600000X Licence 230009497230504 (MI)

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Registry record

NPI: 1386101574
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Feb 2019
Record last updated: 11 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.