Individual
LAKIFFANIE PATRYCE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
7070 KNIGHTS CT STE 1301, MISSOURI CITY, TX 77459-5525
(713) 352-3166
(713) 547-4468
Mailing address
2006 VERMILLION OAK ST, FRESNO, TX 77545-2050
(713) 315-1048
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
754934
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1134383
TX
Other
Enumeration date
01/08/2024
Last updated
04/10/2024
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