Search › Louisiana › 172V00000X
Fannie Jackson
NPI 1659826774 · on the registry since 2016
Practice
- Address
- 5841 S Sherwood Forest Blvd
Baton Rouge, LA 70816 - Phone
- (225) 256-3556
- Organisation at this address
- Family Of Love Provider Service Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 172V00000X
172V00000X
- Sex
- Female
- Record last updated
- 2021-06-16
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