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

Ruth A Jackson, NP

Individual provider Family Nurse Practitioner · NPI 1821731746

Ruth A Jackson, NP is a Nurse Practitioner in Warren, Michigan. Qualified in 2021, 5 years ago. Practices as a sole proprietor. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2022
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone: (586) 576-4904
Fax: (586) 573-5953
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704330240 (MI)

Record details

NPI number1821731746
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedApril 18, 2022
Last updated in NPPESApril 6, 2026
Certification dateApril 6, 2026
Mailing address47650 Barbara Rd, Macomb, MI 48044-2410

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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