Individual
AMI RYNAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1315 JEFFERSON HWY, NEW ORLEANS, LA 70121-2406
(504) 842-3900
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
0001233148
VA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP10123
LA
363LP0200X
Pediatric Nurse Practitioner
SP009725
PA
Other
Enumeration date
11/23/2011
Last updated
04/18/2022
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