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General NPI Number Information
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NPI Number | 1669347639
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Entity Type | Individual
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Provider Name | MARNAE VELEECE COLSTON-JACKSON RN, BSN, MHA, DNP
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Gender | Female
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1253 E 100TH ST
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City | CLEVELAND
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State | OH
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Zip | 44108-3502
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Country | US
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Telephone | 216-795-0688
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Fax | 216-795-0688
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Provider Business Mailing Address
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Address Line | 1253 E 100TH ST
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City | CLEVELAND
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State | OH
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Zip | 44108-3502
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Country | US
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Telephone | 216-795-0688
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Fax | 216-795-0688
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN300474
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License Number State | OH
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