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General NPI Number Information
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NPI Number | 1083896385
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Entity Type | Individual
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Provider Name | BRENDA A JARRETT NP
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Gender | Female
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 1501 KINGS HWY
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City | SHREVEPORT
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State | LA
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Zip | 71103-4228
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Country | US
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Telephone | 318-675-7205
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Fax |
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Provider Business Mailing Address
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Address Line | 509 W 76TH ST
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City | SHREVEPORT
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State | LA
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Zip | 71106-4103
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Country | US
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Telephone | 713-449-3550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN078577-AP06165
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License Number State | LA
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