Healthcare Provider Details

I. General information

NPI: 1396676870
Provider Name (Legal Business Name): YASMEEN AZOOKARI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W MICHIGAN AVE
JACKSON MI
49201-2121
US

IV. Provider business mailing address

3418 MAYAPPLE LN APT 32
JACKSON MI
49201-7286
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-7920
  • Fax:
Mailing address:
  • Phone: 517-787-7920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number6801107678
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: