Healthcare Provider Details

I. General information

NPI: 1376015735
Provider Name (Legal Business Name): LUCIE JHOLEH JONES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S FARMERVILLE ST
RUSTON LA
71270-5941
US

IV. Provider business mailing address

1455 E BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT LA
71105-6000
US

V. Phone/Fax

Practice location:
  • Phone: 318-460-5127
  • Fax: 866-502-4997
Mailing address:
  • Phone: 318-798-4539
  • Fax: 318-798-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number203276
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: