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Staci Nicole Jackson

Case Manager/Care Coordinator in Baton Rouge, LA. Individual provider (NPI-1).

NPI number1801547252
StatusActive
Last updated in NPPESJul 7, 2025

Details

NPI
1801547252
Entity type
Individual (NPI-1)
Name
Staci Nicole Jackson
Sex
Female
Sole proprietor
No
Enumeration date
Jan 17, 2022
Certification date
Jul 7, 2025
Last updated
Jul 7, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator––Yes

Practice location

11408 Lake Sherwood Ave N Ste A
Baton Rouge, LA 70816-0421

Phone 225-261-7143

Mailing address

2136 Lobdell Blvd Apt 2801
Baton Rouge, LA 70806-1333

Phone 225-650-3983

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