Individual
MRS. SHELIA SHENELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7505 PINES RD, STE 1250, SHREVEPORT, LA 71129-3935
(318) 686-3770
(318) 686-3838
Mailing address
7505 PINES RD, STE 1250, SHREVEPORT, LA 71129-3935
(318) 686-3770
(318) 686-3838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
TAP002970
LA
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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