Individual
LILLIAN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8001 YOUREE DR, SUITE 580, SHREVEPORT, LA 71115-2302
(318) 212-3740
(318) 212-3745
Mailing address
8001 YOUREE DR, SUITE 580, SHREVEPORT, LA 71115-2302
(318) 212-3740
(318) 212-3745
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.203008
LA
208000000X
Pediatrics Physician
MD.203008
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07882
—
LA
Enumeration date
05/23/2007
Last updated
07/21/2015
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