Individual
RACINE DOMINIQUE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
211 4TH ST, ALEXANDRIA, LA 71301-8421
(318) 769-3000
Mailing address
2525 W ORICE ROTH RD APT 1510, GONZALES, LA 70737-5336
(225) 348-3997
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
229255
LA
Other
Enumeration date
03/22/2023
Last updated
10/05/2025
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