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Contact Information

WANDA M JACKSON
3100 GENERAL DE GAULLE DR
NEW ORLEANS, LA70114-6632
 Phone: 504-620-3130
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for WANDA M JACKSON · (Female)

NPI Number 1982194635
Status Active
Credentials
Entity Individual
Enumeration date 05/17/2018
Last updated 05/17/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 292534
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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