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Amanda Jackson
NPI 1285905240 · on the registry since 2012 · sole proprietor
Practice
- Address
- 1760 Turning Leaf Trl
Haughton, LA 71037 - Phone
- (501) 249-2247
Registry record
- Primary taxonomy
- 225X00000X
225X00000X
- Also registered as
- 225X00000X
- Licence states on file
- LA, AR
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2012-01-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana