Individual
MS. CASSANDRA E. LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5525 CONCORD DR NE, JACKSON, MS 39211-4237
(205) 373-9710
Mailing address
5525 CONCORD DR NE, JACKSON, MS 39211-4237
(205) 373-9710
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
MS
374U00000X
Home Health Aide
—
MS
376J00000X
Homemaker
Primary
—
MS
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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