Cayla-marie Jackson, RD, LD | |
4301 W Markham St, Slot # 574-01, Little Rock, AR 72205-7101 | |
(150) 186-7062 | |
Not Available |
Full Name | Cayla-marie Jackson |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 4301 W Markham St, Little Rock, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194109660 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Provider Name | University Of Arkansas For Medical Sciences |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1588654016 PECOS PAC ID: 4082528955 Enrollment ID: O20031219000706 |
Mailing Address | Practice Location Address |
---|---|
Cayla-marie Jackson, RD, LD 4301 W Markham St, Slot # 574-01, Little Rock, AR 72205-7101 Ph: () - | Cayla-marie Jackson, RD, LD 4301 W Markham St, Slot # 574-01, Little Rock, AR 72205-7101 Ph: (150) 186-7062 |
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