Individual
MS. MARY SUSAN ANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8932 JEWELLA AVE, SHREVEPORT, LA 71118-2117
(318) 219-4167
Mailing address
1302 PARKWAY CIR, BOSSIER CITY, LA 71112-3740
(318) 393-6572
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
230250
LA
Other
Enumeration date
07/21/2023
Last updated
07/21/2023
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