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General NPI Number Information
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NPI Number | 1619872983
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Entity Type | Organization
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Legal Business Name | JESSICA A SHIELDS MD PLLC
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 1103 KALISTE SALOOM RD STE 100
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City | LAFAYETTE
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State | LA
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Zip | 70508-5784
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Country | US
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Telephone | 337-234-5234
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 KALISTE SALOOM RD STE 100
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City | LAFAYETTE
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State | LA
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Zip | 70508-5784
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Country | US
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Telephone | 337-234-5234
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA SHIELDS
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Credential | MD
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Telephone | 337-315-7927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State | NULL
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