Individual
MISS MARQUITA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11990 JACKSON ST., CLINTON, LA 70722
(225) 683-5292
Mailing address
4506 HIGHWAY 952, JACKSON, LA 70748-3130
(225) 454-5283
(225) 683-4354
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN112654
LA
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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