Individual
SHANNON DENISE JACKSON-WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
8932 JEWELLA AVE STE A, SHREVEPORT, LA 71118-2117
(318) 219-4167
Mailing address
239 DIANE LN, STONEWALL, LA 71078-9507
(318) 235-7554
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
801526
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP07433
LA
Other
Enumeration date
09/25/2013
Last updated
11/04/2024
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