# NIKKITTA ANTOINETTE JACKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1649727637
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | 4703117130 | MI | Yes |
| 225700000X | Massage Therapist | 7501017098 | MI | — |

## Other

- **Enumeration date:** 09/07/2016
- **Last updated:** 12/22/2025