Individual
DR. TERRY LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, ACNPC-AG
Contact information
Practice address
2551 GREENWOOD RD STE 210, SHREVEPORT, LA 71103-3985
(318) 635-0834
(318) 212-3958
Mailing address
2551 GREENWOOD RD STE 210, SHREVEPORT, LA 71103-3985
(318) 635-0834
(318) 212-3958
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
200793
LA
Other
Enumeration date
09/02/2020
Last updated
06/16/2021
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