Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Jacquelyn Lauren Edwards

Individual provider Physician Assistant · NPI 1306250634

MS. Jacquelyn Lauren Edwards is a Physician Assistant in Detroit, Michigan. Qualified in 2014, 12 years ago. Practices with Henry Ford Health System, a 2,540-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
12
Licensed in
MI
In the registry since
2014
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Practice location Address checks out

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone: (800) 436-7936
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 22531 Oconnor St, Saint Clair Shores, MI 48080-2148 — (586) 899-6180

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601006985 (MI)

Record details

NPI number1306250634
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 14, 2014
Last updated in NPPESSeptember 19, 2024
Certification dateSeptember 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Henry Ford Health System — 2540 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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