Individual
MR. JOHNATHAN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 OXFORD PL, BOSSIER CITY, LA 71111-5503
(318) 780-3367
Mailing address
2001 OXFORD PL, BOSSIER CITY, LA 71111-5503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN152086
LA
Other
Enumeration date
11/25/2025
Last updated
11/25/2025
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