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NPI Code Detail

MEDICARE: JESSICA BURKETT

MEDICARE: JESSICA BURKETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianR-24580LA

General Provider Information

NPI Number : 1780530527
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BURKETT
Provider Business Mailing Address
First Line : 123 STEPHANIE DR
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-6975
Country : US
Telephone Number : 318-327-8223
Fax Number :
Provider Business Practice Location Address
First Line : 505 GLENMAR AVE
Second Line :
City : MONROE
State : LA
Zip : 71201-5309
Country : US
Telephone Number : 318-327-8223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/05/2026

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Directions to “ JESSICA BURKETT ” Practice Location

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