Search › Louisiana › 172A00000X
Demetris Jackson
NPI 1699342287 · on the registry since 2021
Practice
- Address
- 3406 E Louisiana State Dr
Kenner, LA 70065 - Phone
- (504) 380-2792
- Organisation at this address
- Juanitas Transportation Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 172A00000X
172A00000X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-06-10
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