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

Tynetta Jackson

Individual provider Licensed Practical Nurse · NPI 1932898269

Tynetta Jackson is a Licensed Practical Nurse in Roseville, Michigan. Licensed in Michigan. Registered with an NPI since 2023.

Licensed in
MI
In the registry since
2023

Practice location Address checks out

27621 Groveland St
Roseville, MI 48066-4353
Phone: (248) 678-5637
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 4703124495 (MI)

Record details

NPI number1932898269
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 3, 2023
Last updated in NPPESMay 3, 2023
Certification dateMay 3, 2023
Mailing address27621 Groveland St, Roseville, MI 48066-4353

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