RAVEN S JACKSON


Address: 1111 Medical Center Blvd, S 850, Marrero, LA 70072-3151
Phone: 5043496450

RAVEN S JACKSON (NPI# 1285034553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285034553
Entity Type Individual
Full Name RAVEN S JACKSON
Credential PHARMD
Practice Address 1111 Medical Center Blvd
S 850
Marrero
LA 70072-3151
Practice Telephone 5043496450
Practice Fax Number 5043496454
Mailing Telephone 5043496450
Mailing Fax Number 5043496454
Enumeration Date 2014-08-24
Last Update Date 2016-11-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 183500000X Pharmacist PST.021789 LA Pharmacy Service Providers
N 183500000X Pharmacist 26025677A IN Pharmacy Service Providers

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1801406186 Raven Julia Jackson Dentist 445 Tn-46 S, Dickson, TN 37055 2020-08-03
1508167917 Raven A Jackson Physical Therapist 19 Brinsley St, Dorchester, MA 02121-3607 2010-11-16
1942745823 Raven Jackson Counselor 4951 Central Avenue, Monroe, LA 71203 2016-12-30

Office Location

Street Address 1111 MEDICAL CENTER BLVD
S 850
City MARRERO
State LA
Zip Code 70072-3151

Providers in the same location

NPI Name Taxonomy Address Enumeration
1487657359 West Jefferson Surgery Center, LLC Clinic/Center 1111 Medical Center Blvd, Ste 105n, Marrero, LA 70072-3152 2005-05-24
1972129211 Marissa Liantonio Miller Nurse Practitioner 1111 Medical Center Blvd, Marrero, LA 70072-3151 2020-06-23
1952920324 Kirstie Rae Schieffler Physician Assistant 1111 Medical Center Blvd, Marrero, LA 70072-3151 2020-04-15
1841730918 Samantha Schenker Nurse Practitioner 1111 Medical Center Blvd, N406, Marrero, LA 70072-3151 2017-03-08
1376092379 Shelli Rodriguez Ergen Nurse Practitioner 1111 Medical Center Blvd, Suite South 113, Marrero, LA 70072-3151 2016-10-02
1326418443 Cain Foot Center, LLC Podiatrist 1111 Medical Center Blvd, Suite N-313, Marrero, LA 70072-3151 2015-10-01
1235515693 Joseph Guarnieri Eyewear Supplier (Equipment, not the service) 1111 Medical Center Blvd, Suite N-114, Marrero, LA 70072-3151 2015-08-07
1639552979 Kelly Thibodeaux Nurse Practitioner 1111 Medical Center Blvd, 350s, Marrero, LA 70072-3151 2015-07-06
1629478409 Ochsner Clinic LLC General Practice 1111 Medical Center Blvd, Suite 313n, Marrero, LA 70072-3151 2014-08-28
1457767717 Elisabeth Lifsey-wood Nurse Anesthetist, Certified Registered 1111 Medical Center Blvd, Marrero, LA 70072-3151 2014-07-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780232579 Brittany Inez Young Technician 4465 Bay View Drive, Marrero, LA 70072 2019-08-27
1356829774 Zachary Allen Runge Kleinpeter Physician Assistant 1111 Medical Center Blvd Ste S630, Marrero, LA 70072 2018-07-30
1689172611 Derron White Specialist 2324 Barataria Blvd, Marrero, LA 70072 2018-01-24
1477064616 Bone & Joint, LLC Physical Therapy Physical Therapist 4633 Wichers Dr., Marrero, LA 70072 2017-10-16
1477077410 Darlene Jenkins Case Manager/Care Coordinator 7606 Westbank Expy Ste B, Marrero, LA 70072 2017-08-01
1871017186 Tyra K Haynes Non-emergency Medical Transport (VAN) 536 Westwood Drive, Marrero, LA 70072 2017-07-28
1265961536 Danika Kayelle Frank Social Worker 6189 Boutte St, Marrero, LA 70072 2017-06-08
1528596673 Monica Cheree Mayberry Counselor 931 Westwood Dr., Marrero, LA 70072 2017-06-01
1710419197 Sharla Black Counselor 2069 Paine Drive, Marrero, LA 70072 2017-04-03
1699207043 Tango Austin Counselor 2573 Foliage Drive, Marrero, LA 70072 2017-04-03
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Taxonomy Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225679566 Michelle Ngoc Anh Tran Pharmacist 7417 Etude Dr, Marrero, LA 70072-5992 2019-10-07
1578063699 Megan Marie Mckay Pharmacist 2 Briarfield Dr, Marrero, LA 70072-5063 2018-02-15
1194126672 Michael Le Nhat Thien Vu Pharmacist 1644 Jutland Dr, Marrero, LA 70072-4331 2014-09-15
1629479100 Jimmy Quach Pharmacist 2557 Crestwood Rd, Marrero, LA 70072-5704 2014-09-15
1275892408 Son Kim Pharmacist 1250 Sinskey Dr, Marrero, LA 70072-5997 2012-05-08
1932414133 Ngoc-phuong Thi Nguyen Pharmacist 4535 Westbank Expy, Marrero, LA 70072-3120 2010-08-11
1124332713 Hong Tham Tran Pharmacist 4704 4th St, Marrero, LA 70072-1905 2010-08-06
1174845705 Craig M Levet Pharmacist 1111 Medical Center Blvd Ste 116n, Marrero, LA 70072-3157 2010-02-23
1073759676 Allan Gerard Lepine Pharmacist 5020 Middlebury St, Marrero, LA 70072-5528 2009-01-02
1265652630 Rosheba Shanee Morgan Pharmacist 5969 Lapalco Blvd, Marrero, LA 70072-4833 2007-04-26
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Competitor

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City MARRERO
Zip Code 70072

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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