Wellness Center For Skin Therapy Llc

NPI 1053705574 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1053705574
Enumeration Date 03/23/2015
Last Updated 03/23/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name JENNIFER BURNS JENNIFER
Position OWNER
Phone (318) 221-2821
Fax
Practice Location
2751 ALBERT L BICKNELL DR
SUITE 1A
SHREVEPORT LA, 71103-3920, US
Phone (318) 221-2821
Fax
Business Location
2751 ALBERT L BICKNELL DR
SUITE 3A
SHREVEPORT LA, 71103-3920, US
Phone (318) 636-9905
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State Louisiana
License Number AP03173
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According to our database, Wellness Center For Skin Therapy Llc NPI is 1053705574, taxonomy code is 363LF0000X and license number is AP03173, license state is located at Louisiana. Wellness Center For Skin Therapy Llc physically located at 2751 Albert L Bicknell Dr, Shreveport LA, 71103-3920. NPI Number 1033115704 has the healthcare provider type.

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1053705574 NPI number is provided on an as is basis without warranty of any kind. 1053705574 is maintained by the National Plan & Provider Enumeration System. The contents of Wellness Center For Skin Therapy Llc are for informational purposes only.