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Individual

MRS. JENNIFER MICHELLE MIDDLETON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7505 PINES RD STE 1235, SHREVEPORT, LA 71129-3900
(225) 932-9150
Mailing address
6900 BUNCOMBE RD LOT 61, SHREVEPORT, LA 71129-9496
(318) 834-8187

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG07170253
LA

Other

Enumeration date
11/03/2017
Last updated
11/03/2017
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