Individual
JENNA VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
506 ROCK HOLLOW DR, SHREVEPORT, LA 71115-2502
(318) 470-0447
Mailing address
506 ROCK HOLLOW DR, SHREVEPORT, LA 71115-2502
(318) 470-0447
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09009
LA
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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