Individual
JENNIFER TUPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP STE 101, SHREVEPORT, LA 71118-3175
(318) 212-5811
(318) 212-5844
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP STE 101, SHREVEPORT, LA 71118-3175
(318) 212-5811
(318) 212-5844
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
124754
LA
363LP0200X
Pediatric Nurse Practitioner
1140664
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
227608
LA
Other
Enumeration date
07/06/2019
Last updated
09/12/2025
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