Individual
MRS. JENNIFER E NETTERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
(903) 315-2000
Mailing address
392 HALF MOON CT, BOSSIER CITY, LA 71111-5569
(318) 347-5591
(318) 222-0724
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
113324
LA
163W00000X
Registered Nurse
779616
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP06036
LA
Other
Enumeration date
01/02/2010
Last updated
06/27/2019
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