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Individual

DR. JACELYN JADE ROUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
235 FRONTAGE RD, PICAYUNE, MS 39466-7514
(601) 799-1063
Mailing address
74640 TANTELA RANCH RD, COVINGTON, LA 70435-7092
(601) 916-0279

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-102026
MS

Other

Enumeration date
07/22/2025
Last updated
07/22/2025
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