Individual
ASHLEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2116 N BOLTON AVE, ALEXANDRIA, LA 71303-4405
(318) 445-1250
Mailing address
610 E WASHINGTON ST, VILLE PLATTE, LA 70586-4628
(337) 459-8823
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20110741
LA
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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