Individual
JENNA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2880 HIGHWAY 190, MANDEVILLE, LA 70471-3254
(985) 624-8548
Mailing address
25 WILLARD PL, WESTWEGO, LA 70094-5502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.024703
LA
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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