Mrs. Wanda Kay Jackson
Dental Hygienist
510 E Stoner Ave #160
Shreveport
, Louisiana 71101-4243
Mrs. Wanda Kay Jackson
Dental Hygienist
510 E Stoner Ave #160
Shreveport
, Louisiana 71101-4243
(318) 841-4795
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About
Features
Specialties
- Dental Hygienist
Languages spoken
- English
Location
First Address
- Mrs. Wanda Kay Jackson
- 510 E Stoner Ave #160
- Shreveport, LA
- Zip : 71101-4243
- Fax : (318) 841-4795
- Phone : (318) 221-8411
Second Address
- Mrs. Wanda Kay Jackson
- 510 E Stoner Ave #160
- Shreveport, LA
- Zip : 71101-4243
- Fax : (318) 841-4795
- Phone : (318) 221-8411
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 376 | LA |
National Provider Identifier
| NPI | 1043323504 |
|---|---|
| Provider Name | Mrs. Wanda Kay Jackson |
| First Address | Shreveport, LA 71101-4243 |
| Second Address | Shreveport, LA 71101-4243 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/08/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.