Naomi Jefferson Jackson

Individual provider Active NPI Case Manager/Care Coordinator · Lake Charles, LA

NPI 1164948899 · NPPES record last updated Mar 23, 2022

Key facts

NPI
1164948899
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1333 Common St
Lake Charles, LA 70601-5255
Phone
(337) 437-4014
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1333 Common St
Lake Charles, LA 70601-5255

Mailing address

2525 Youree Dr. Suite 110
Shreveport, LA 71104
Phone (318) 742-3408

Other names

  • Mrs. Naomi Jefferson Matthews Former name

Other providers in Lake Charles, LA

All providers in Lake Charles, LA · Case Manager/Care Coordinator in Louisiana

Sources for this page

Verify at the official NPI Registry.