Provider Demographics
NPI:1174717375
Name:JACKEL, ELIZABETH VOSS (APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:VOSS
Last Name:JACKEL
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MARIE
Other - Last Name:VOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4401 S CLAIBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-5105
Mailing Address - Country:US
Mailing Address - Phone:504-957-5448
Mailing Address - Fax:
Practice Address - Street 1:2200 8TH ST
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-4006
Practice Address - Country:US
Practice Address - Phone:504-367-4407
Practice Address - Fax:504-367-4327
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04134363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1141135Medicaid