NPIMap

Organization Active NPI

Wellness Center for Skin Therapy LLC

  • Family Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1053705574
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP03173 Issued in LA
Legal business name
WELLNESS CENTER FOR SKIN THERAPY LLC
Practice address
2751 Albert L Bicknell Dr
Suite 1a
Shreveport, LA 71103-3920
Phone
(318) 221-2821
NPI assigned
Mar 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Burns Norwood, FNP-C
Title
Owner
Phone
(318) 636-9905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP03173 LA Primary

Addresses

Primary practice location

2751 Albert L Bicknell Dr
Suite 1a
Shreveport, LA 71103-3920

Mailing address

2751 Albert L Bicknell Dr
Suite 3a
Shreveport, LA 71103-3920
Phone (318) 636-9905

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427068800000",
    "number": "1053705574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "address_2": "SUITE 3A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-636-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "address_2": "SUITE 1A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-221-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS CENTER FOR SKIN THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-23",
        "last_updated": "2015-03-23",
        "status": "A",
        "authorized_official_last_name": "NORWOOD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BURNS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-636-9905",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP03173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.