Individual
SHARON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP
Contact information
Practice address
5247 DIDESSE DR, BATON ROUGE, LA 70808
(225) 765-7632
(225) 215-2194
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN115717 AP06897
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2309544
—
LA
01
—
RN115717 AP06897
LOUISIANA STATE BOARD OF NURSE EXAMINERS
LA
Enumeration date
07/24/2012
Last updated
03/26/2021
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