DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MS. AUDRA L JACKSON CRNA

MEDICARE: MS. AUDRA L JACKSON CRNA
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
1367500000XCertified Registered Nurse Anesthetist142779MO
2367500000XCertified Registered Nurse AnesthetistAP12634MO
3367500000XCertified Registered Nurse AnesthetistAP126342TX

General Provider Information

NPI Number : 1861472953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AUDRA L JACKSON CRNA
Provider Business Mailing Address
First Line : 1002 GEMINI ST STE 128
Second Line :
City : HOUSTON
State : TX
Zip : 77058-2746
Country : US
Telephone Number : 281-218-9515
Fax Number : 281-218-9534
Provider Business Practice Location Address
First Line : 1002 GEMINI ST STE 128
Second Line :
City : HOUSTON
State : TX
Zip : 77058-2746
Country : US
Telephone Number : 281-218-9515
Fax Number : 281-218-9534
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 08/18/2022

Similar Medicare Providers

1497740294 — PONDA ELIZABETH SALLEE CRNA
Practice Location Address:
1002 GEMINI ST STE 128
HOUSTON, TX
77058-2746
Practice Phone: 281-218-9515
Practice Fax: 281-218-9534
1578515185 — JOHN D MILLER CRNA
Practice Location Address:
1002 GEMINI ST STE 128
HOUSTON, TX
77058-2746
Practice Phone: 281-218-9515
Practice Fax: 281-218-9534
1821027301 — DR. PATRICK KOONS JR. MD
Practice Location Address:
1002 GEMINI ST STE 128
HOUSTON, TX
77058-2746
Practice Phone: 281-218-9515
Practice Fax: 281-218-9515
1629170519 — DR. DAVID MORRIS WIMBERLY MD
Practice Location Address:
1002 GEMINI ST STE 128
HOUSTON, TX
77058-2746
Practice Phone: 281-218-9515
Practice Fax: 281-218-9534
1275634388 — DR. BHASKARA M PONNURU MD
Practice Location Address:
1002 GEMINI ST STE 128
HOUSTON, TX
77058-2746
Practice Phone: 281-218-9515
Practice Fax:
1780731646 — DR. KRISTALYNNE GODWIN MD
Practice Location Address:
1002 GEMINI ST STE 128
HOUSTON, TX
77058-2746
Practice Phone: 281-218-9515
Practice Fax:

Directions to “ MS. AUDRA L JACKSON CRNA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.