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Individual

JENNIFER SHELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
908 SILO AVE, MARIETTA, OK 73448-7308
(209) 324-3863
Mailing address
1204 STUBBS AVE STE B, MONROE, LA 71201-5631
(318) 582-5633

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171M00000X
LA
Enumeration date
12/07/2020
Last updated
03/15/2021
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