Individual
JOLONDRA SHEREE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MARX ST, MONROE, LA 71202-3417
(318) 600-6978
(318) 600-6978
Mailing address
111 MARX ST, MONROE, LA 71202-3417
(318) 600-6978
(318) 600-6978
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
008495845
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000271280
—
LA
Enumeration date
09/27/2016
Last updated
09/27/2016
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