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General NPI Number Information
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NPI Number | 1467262691
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Entity Type | Individual
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Provider Name | JACKLYN FLEURY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN ST
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City | DETROIT
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State | MI
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Zip | 48201-2196
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Country | US
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Telephone | 313-966-8510
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Fax |
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Provider Business Mailing Address
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Address Line | 48425 ROMEO PLANK RD
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City | MACOMB
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State | MI
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Zip | 48044-2103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0200X
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Taxonomy Name | Pediatric Pharmacist
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License Number | 5302416522
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License Number State | MI
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