Wanda Jackson, RDH

NPI 1043323504 · on the registry since 2006

Practice

Address: 510 E Stoner Ave
#160
Shreveport, LA 71101
Phone: (318) 221-8411
Fax: (318) 841-4795
Organisation at this address: Obvamc
Shreveport Vamc
Shreveport Vamc
Shreveport Vamc
Shreveport Vamc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 491

Registry record

Primary taxonomy: Dental Hygienist
124Q00000X
Licence states on file: LA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana