NPI 1023610151
Jenna Nura Jackson, PA-C
Physician Assistant · Hazel Park, MI
Active in the CMS NPI RegistryNot on the OIG exclusion listchecked Oct 14, 2026, 9:45 pm EDT
See the full record in NPI Lookup
Licenses with board links, Medicare enrollment, the verification report, industry payments and published research, plus Excel and PDF downloads.
Jenna Nura Jackson, PA-C is a health care provider (Physician Assistant) in Hazel Park, Michigan with National Provider Identifier (NPI) 1023610151. The NPI was issued on Nov 13, 2020 and the registry record was last updated on Dec 1, 2020. The registry lists a license in Michigan.
Registry record
- NPI
- 1023610151
- Type
- Individual (NPI-1), sole proprietor
- Primary specialty
- Physician Assistant 363A00000X
- Practice location
- 624 E 9 Mile Rd
Hazel Park, MI 48030-1842 - Phone
- (248) 629-7497
- NPI issued
- Nov 13, 2020
- Registry record updated
- Dec 1, 2020
Specialties and licenses
| Specialty | Taxonomy code | License state | License |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | Michigan | 5601010079 |
Confirm license status and discipline with the state board (links in NPI Lookup).
Physician Assistant providers in Michigan
- Jonathan Moseley, PA-CNorthville, MI
- Christopher Davis, PA-CMount Clemens, MI
- Tiffany Angel Findlay, PA-CWyandotte, MI
Source: CMS National Plan and Provider Enumeration System (NPPES) and the HHS-OIG List of Excluded Individuals/Entities (list of Oct 9, 2026). Is this your record? Update it in NPPES or email info@2minutemedicine.com to have it hidden here.