Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PHYLLIS ST AMANT JACKSON
Active Sole ProprietorPHYLLIS ST AMANT JACKSON is a Contractor healthcare provider located in BATON ROUGE, Louisiana. NPI 1104283340 is currently active in the NPPES registry. Verify at CMS.
Contractor · BATON ROUGE, LA
Registration Details
- NPI Number
- 1104283340
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 19, 2016 (10.588473936859 yrs)
- Last Updated
- Jan 19, 2016
- Sole Proprietor
- Yes
Practice Information
- Address
-
13317 SOUTH CHOCTAW DRIVESUITE C3BATON ROUGE, LA, 70815Browse LA providers · Browse ZIP 70815
- Phone
- 2253646208
- Primary Specialty
-
Contractor
171W00000X
Other Contractor Providers in BATON ROUGE, LA
| Name | Credential | NPI |
|---|---|---|
| MR. DANE ESTEL HUPP | M.S.P.T. | 1891829636 |
| MRS. DEBRA BROWN BOURGOYNE | OT | 1144426990 |
| KAREN W WHITE | PT, DPT | 1598947574 |
| MR. RODNEY JEROME SELDERS | — | 1841421468 |
| DIANA MICHELE SAUL STEWART | LOTR | 1871837195 |
| MR. JOHN MARIEN | — | 1184046773 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.