Individual
CHAUNA H JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7200 CYPRESS LAKES APARTMENT BLVD APT 601, BATON ROUGE, LA 70809-5307
(225) 223-8993
Mailing address
7200 CYPRESS LAKES APARTMENT BLVD APT 601, BATON ROUGE, LA 70809-5307
(225) 223-8993
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
008538804
LA
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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