Individual
JACQULINE D JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8001 YOUREE DR STE 400, SHREVEPORT, LA 71115-2340
(182) 123-8213
(318) 212-3825
Mailing address
PO BOX 372, PANOLA, TX 75685-0372
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1004883
TX
Other
Enumeration date
08/22/2020
Last updated
06/17/2021
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