Individual
JANNA KIRSTEN FLINT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4704 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6908
(337) 470-5920
(337) 289-9860
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(337) 470-5920
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
036.118014
IL
2080P0205X
Pediatric Endocrinology Physician
Primary
MD.202173
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1175650
—
LA
Enumeration date
11/24/2006
Last updated
02/01/2022
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