Individual
CAROLYN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 MAIN ST STE 2200, BATON ROUGE, LA 70801-0014
(225) 224-6780
(225) 226-6701
Mailing address
301 MAIN ST STE 2200, BATON ROUGE, LA 70801-0014
(225) 224-6780
(225) 226-6701
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
00922173
LA
Other
Enumeration date
11/20/2016
Last updated
11/20/2016
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