Individual
TAMARA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3755
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN102704 AP05399
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN102704 AP05399
CRNA LIC
LA
Enumeration date
05/02/2008
Last updated
12/30/2022
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