Individual
SHIRELL ROBINSON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20181 SKINNER DR, HAMMOND, LA 70401-4022
(985) 215-1538
Mailing address
20181 SKINNER DR, HAMMOND, LA 70401-4022
(985) 215-1538
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
007029882
LA
172A00000X
Driver
—
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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