Individual
MRS. JENNIFER HALEY WADDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
2508 BERT KOUN LOOP, SUITE 201, SHREVEPORT, LA 71118-3133
(318) 212-5790
(318) 212-5795
Mailing address
2508 BERT KOUN LOOP, SUITE 201, SHREVEPORT, LA 71118-3133
(318) 212-5790
(318) 212-5795
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP04789
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP04789
APRN
LA
01
—
RN098243
LICENSE---NURSING
LA
Enumeration date
05/09/2007
Last updated
04/13/2016
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