Individual
MRS. JESSICA ELLEN CREDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2106 LOOP RD STE B, WINNSBORO, LA 71295-3343
(318) 239-4860
(805) 295-4715
Mailing address
PO BOX 4506, SHREVEPORT, LA 71134-0506
(318) 239-4860
(805) 295-4715
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
224185
LA
Other
Enumeration date
12/23/2021
Last updated
02/22/2022
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