Individual
JENNA NICOLE BLUNDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1811 E BERT KOUNS INDUSTRIAL LOOP STE 210, SHREVEPORT, LA 71105-5740
(318) 212-3858
Mailing address
122 RAGAN LN, HAUGHTON, LA 71037-8994
(641) 990-3361
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
216026
LA
Other
Enumeration date
10/19/2020
Last updated
06/18/2021
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