Individual
MANDY KATHERYN MCNAMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
103 WATTS ST, JONESBORO, LA 71251-2053
(318) 259-1569
(318) 259-8523
Mailing address
820 JORDAN ST, STE 201, SHREVEPORT, LA 71101-4518
(318) 259-1569
(318) 259-8523
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
300023
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300023
LICENSE #
LA
Enumeration date
10/12/2015
Last updated
06/13/2016
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