Healthcare Provider Details

I. General information

NPI: 1598989220
Provider Name (Legal Business Name): NIKKI LEIGH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7119 HWY 1 SOUTH
MARKSVILLE LA
71351
US

IV. Provider business mailing address

PO BOX 13524
ALEXANDRIA LA
71315-3524
US

V. Phone/Fax

Practice location:
  • Phone: 318-253-6553
  • Fax:
Mailing address:
  • Phone: 318-445-4477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFERY A. CAUBARREAUX
Title or Position: OWNER
Credential:
Phone: 318-253-6553