Organization
WELLNESS CENTER FOR SKIN THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BURNS NORWOOD FNP-C (OWNER)
(318) 636-9905
Entity
Organization
Contact information
Practice address
2751 ALBERT L BICKNELL DR, SUITE 1A, SHREVEPORT, LA 71103-3920
(318) 221-2821
Mailing address
2751 ALBERT L BICKNELL DR, SUITE 3A, SHREVEPORT, LA 71103-3920
(318) 636-9905
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP03173
LA
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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