NPI Profile for TANYA JACKSON in MARRERO, LA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers |
| NPI # | 1356431555 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 10/16/2006 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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TANYA JACKSON
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