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1669060034
JERRY LLOYD WILLIFORD
SHREVEPORT, LA
NPI
1669060034
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: LA 211128)
Enumeration Date
2021-01-01
Last Update Date
2021-01-01
Business Address
JERRY LLOYD WILLIFORD Nurse Practitioner
850 OLIVE ST STE A
SHREVEPORT, LA 71104-2162
Phone number: 318-239-4860
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Mailing Address
JERRY LLOYD WILLIFORD Nurse Practitioner
PO BOX 4506
SHREVEPORT, LA 71134-0506
Phone number: 318-239-4860
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