Individual
MRS. JEANETTA GLENESE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
320 LORI DR, STONEWALL, LA 71078-9629
(318) 422-7511
Mailing address
320 LORI DR, STONEWALL, LA 71078-9629
(318) 422-7511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN147984
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN147984
RN LICENSE
LA
Enumeration date
05/28/2022
Last updated
04/24/2024
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