Individual
SERENA DEANN WILKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3331 YOUREE DR, SHREVEPORT, LA 71105
(318) 868-6555
(318) 868-6009
Mailing address
3331 YOUREE DR, SHREVEPORT, LA 71105-2115
(318) 868-6555
(318) 868-6009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
312719
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2417401
—
LA
Enumeration date
04/05/2016
Last updated
08/27/2019
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