MRS. JENNIFER HALEY WADDLE (NPI# 1366656787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366656787 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER HALEY WADDLE |
| Credential | WHCNP |
| Practice Address |
2508 Bert Koun Loop Suite 201 Shreveport LA 71118-3133 |
| Practice Telephone | 3182125790 |
| Practice Fax Number | 3182125795 |
| Mailing Telephone | 3182125790 |
| Mailing Fax Number | 3182125795 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2016-04-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
AP04789 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | APRN | AP04789 | 01 |
| LA | LICENSE---NURSING | RN098243 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598137408 | Jennifer Waddle | Technician, Other | 815 W 5th North St, Morristown, TN 37814-3810 | 2015-10-30 |
| Street Address |
2508 BERT KOUN LOOP SUITE 201 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730155581 | Sunny Zaheed Hussain | Pediatrics | 2508 Bert Koun Loop, Suite 101, Shreveport, LA 71118-3133 | 2006-02-23 |
| 1003285255 | Wk Digestive Disease Consultants | Internal Medicine | 2508 Bert Koun Loop, Sutie 304, Shreveport, LA 71118-3133 | 2015-09-17 |
| 1073879334 | Amanda Hammad Bunton | Obstetrics & Gynecology | 2508 Bert Koun Loop, Suite 201, Shreveport, LA 71118-3133 | 2012-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093349078 | Alysha Hinson | Nurse Practitioner | 1455 E Bert Kouns Industrial Loop Ste 306, Shreveport, LA 71105-5634 | 2020-02-27 |
| 1356759153 | Mary Tillman Acosta | Nurse Practitioner | 8001 Youree Dr Ste 320, Shreveport, LA 71115-2354 | 2014-07-24 |
| 1265725402 | Katherine Maranto Salley | Nurse Practitioner | 827 Margaret Pl, Suite 201, Shreveport, LA 71101-4523 | 2011-05-20 |
| 1811030018 | Rosalyn J Ferriss | Nurse Practitioner | 1035 Creswell Ave, Shreveport, LA 71101-3917 | 2007-02-15 |
| 1003900564 | Tamara J Trainer | Nurse Practitioner | 1525 Fairfield Room 551, Dhh-office of Public Health, Shreveport, LA 71101 | 2006-10-02 |
| 1851991947 | Gina Marie Kristiansen | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-28 |
| 1447805742 | Emily Green | Nurse Practitioner | 2120 Bert Kouns Industrial Loop Ste A, Shreveport, LA 71118-3351 | 2019-08-05 |
| 1245885540 | Kayla Marie Bryant | Nurse Practitioner | 2401 Greenwood Rd, Shreveport, LA 71103-4010 | 2019-08-05 |
| 1073049995 | Holly Johnson | Nurse Practitioner | 8001 Youree Dr, Suite 600, Shreveport, LA 71115-2302 | 2017-05-11 |
| 1801336706 | Dia M. Johnson | Nurse Practitioner | 1525 Fairfield Ave Ste 569, Shreveport, LA 71101-4331 | 2017-02-27 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
Please comment or provide details below to improve the information on MRS. JENNIFER HALEY WADDLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.