Individual
ALLISON R. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18901 GREENWELL SPRINGS RD, GREENWELL SPRINGS, LA 70739-4827
(225) 924-9985
(225) 924-0884
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(257) 655-7272
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10363
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1582573
—
LA
Enumeration date
03/08/2006
Last updated
03/26/2021
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