Healthcare Provider Details

I. General information

NPI: 1184411050
Provider Name (Legal Business Name): BRITTNEY BAYLOR JACKSON CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 SWEETBRIAR DR
ALEXANDRIA LA
71303-3346
US

IV. Provider business mailing address

807 SWEETBRIAR DR
ALEXANDRIA LA
71303-3346
US

V. Phone/Fax

Practice location:
  • Phone: 318-792-7073
  • Fax:
Mailing address:
  • Phone: 318-792-7073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1710I1003X
TaxonomyIndependent Duty Medical Technicians
License Number335913
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number335913
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License Number335913
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number335913
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License Number335913
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number335913
License Number StateLA
# 7
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number335913
License Number StateLA
# 8
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number335913
License Number StateLA
# 9
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number335913
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: