Individual
MISS TOMEKA SHANTEL SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3450 JACKSON ST, SHREVEPORT, LA 71109-4233
(318) 617-5769
Mailing address
3450 JACKSON ST, SHREVEPORT, LA 71109-4233
(318) 617-5769
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
347944
TX
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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