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Individual

JASON DEAN SHEARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3000
Mailing address
12809 THOMAS JEFFERSON ST, MANOR, TX 78653-3921
(936) 645-0166

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP08210
LA
363LA2100X
Acute Care Nurse Practitioner
AP126886
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07750381
MS
05
2390741
LA
Enumeration date
04/08/2015
Last updated
12/17/2015
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