Individual
LANIKKI JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
430 MISSOURI AVE, NEW MADRID, MO 63869-1420
(573) 936-6735
Mailing address
430 MISSOURI AVE, NEW MADRID, MO 63869-1420
(573) 936-6735
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
MO
Other
Enumeration date
07/31/2024
Last updated
10/28/2025
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