Jennifer Michelle Middleton, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG07170253 Issued in LA

Practice address

7505 Pines Rd Ste 1235
Shreveport, LA 71129-3900

Phone

(225) 932-9150

NPI assigned

Nov 3, 2017

Last updated

Nov 3, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509667200000",
    "number": "1255843801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 BUNCOMBE RD LOT 61",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711299496",
            "telephone_number": "318-834-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 PINES RD STE 1235",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711293900",
            "telephone_number": "225-932-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-03",
        "last_updated": "2017-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "LA",
            "license": "AG07170253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mid City Pediatrics
• Mid-City Family Clinic, LLC
• Midday Surgical Consultants, LLC
• Eiyana Middleton
• Janice E Middleton, LPC
• Midsouth Medical, Inc.
• Cary H Mielke, M.D.
• Kelli Bagley Miers, OT
• Michael W. Miguez, MD
• Mihir V Patel MD LLC

• Gerontology Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Gerontology Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; 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.