Active NPI
Jenna Jackson, PHARMD
- Pharmacist
- Mandeville, LA
National Provider Identifier
1356047070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.024703
- Practice address
- 2880 Highway 190
Mandeville, LA 70471-3254 - Phone
- (985) 624-8548
- NPI assigned
- Feb 3, 2023
- Last updated
- Feb 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.024703 | LA | Primary |
Addresses
Primary practice location
2880 Highway 190
Mandeville, LA 70471-3254
Mailing address
25 Willard PL
Westwego, LA 70094-5502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.024703 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675382400000",
"number": "1356047070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 WILLARD PL",
"city": "WESTWEGO",
"state": "LA",
"postal_code": "700945502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2880 HIGHWAY 190",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704713254",
"telephone_number": "985-624-8548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JENNA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-03",
"last_updated": "2023-02-03",
"certification_date": "2023-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.024703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
- Integrated Wellness Group LLC (Integrated Spine & Disc)
- Integrity Physical Therapy LLC (Integrity Physical Therapy)
- Interim Healthcare San Jose LLC (Interim Healthcare Hospice of East Louisiana)
- Francesca Inzina
- Chris Joseph Ivanyisky, RPH
- Jacob Dent, D.D.S., Dentists of Mandeville, a Professional Corporation (Dentists of Mandeville)
- Lisa Donze Jacob, LCSW
- Karen Aleta Jacobs Spears
- Almore Raymond James Sr., MENTAL HEALTH SPECIA
- Kelly Sharp James, MS, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.