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Ebony Jackson
NPI 1871022699 · on the registry since 2017
Practice
- Address
- 3084 Westfork Dr Ste C
Baton Rouge, LA 70816 - Phone
- (225) 296-6083
- Organisation at this address
- Foundation X Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 60
Additional practice sites
- 3233 S Sherwood Forest Blvd Ste 204, Baton Rouge, LA
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 101Y00000X
171M00000X - Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-09-17
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