Individual
JERCIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17759 LAKE AZALEA DR, BATON ROUGE, LA 70817-9517
(225) 250-0494
Mailing address
17759 LAKE AZALEA DR, BATON ROUGE, LA 70817-9517
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN143215
LA
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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