Individual
MISS JACQUELINE LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PROVIDE CARE
Contact information
Practice address
1842 MURPHY ST, SHREVEPORT, LA 71103-2919
(318) 834-8136
Mailing address
1842 MURPHY ST, SHREVEPORT, LA 71103-2919
(318) 834-8136
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
00294507
LA
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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