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Contact Information

TYMESHIA M JACKSON
54023 WHITPALM DR # B
INDEPENDENCE, LA70443-3123
 Phone: 985-306-2788
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Taxi

344600000X
Indicates primary specialty

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

NPI # 1790649382
Status Active
Credentials
Entity Individual
Enumeration date 12/10/2025
Last updated 12/10/2025 - About 6 months ago
Sole proprietor 1 Yes
Identifiers
  • LA License # 01030048
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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