Individual
MS. AUDRA L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1002 GEMINI ST STE 128, HOUSTON, TX 77058-2746
(281) 218-9515
(281) 218-9534
Mailing address
1002 GEMINI ST STE 128, HOUSTON, TX 77058-2746
(281) 218-9515
(281) 218-9534
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
142779
MO
367500000X
Certified Registered Nurse Anesthetist
AP12634
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
AP126342
TX
Other
Enumeration date
01/17/2006
Last updated
08/18/2022
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