IndividualActive
Charity Otieno
NPI 1154985414 · Primary Care Nurse Practitioner · Jackson, MI
Provider details
- NPI number
- 1154985414
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 4204267626 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3333 Spring Arbor Rd
Jackson, MI 49203-8605
Phone: (517) 205-1000
Approximate (ZIP-level) locationGet directions
Mailing address
1 Ford Pl Ste 3a
Detroit, MI 48202-3450
Registry dates
- Enumerated
- 2019-04-23
- Last updated
- 2023-01-30
- Certified
- 2023-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.