Individual
MISS JAMIE LYNN JUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3925
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3925
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200828
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07909259
—
MS
05
—
2404431
—
LA
Enumeration date
08/20/2015
Last updated
12/01/2015
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