Lazorria Nicole Jackson
Individual provider Active NPI Case Manager/Care Coordinator · Lake Providence, LA
NPI 1881309151 · NPPES record last updated Dec 24, 2024
Key facts
- NPI
- 1881309151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1700 Lake St
Lake Providence, LA 71254-5208 - Phone
- (318) 559-0551
- Fax
- (318) 559-0538
- NPI assigned
- Jan 20, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Positive Pathways, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
1700 Lake St
Lake Providence, LA 71254-5208
Mailing address
1700 Lake St
Lake Providence, LA 71254-5208
Phone (318) 559-0551
Other providers in Lake Providence, LA
- Jensen Taylor Howard
- Integrity Transportation, LLC
- Helen Jackson
- James Jackson
- Joseph Granville Jackson
- Mishelai Ariyan James
- Harriet Hope Johnson
- Clifton Jones Jr.
- Terry Glen Jordan
- Just Health
All providers in Lake Providence, LA · Case Manager/Care Coordinator in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.