Wilden, Jessica Anne
Wilden, Jessica Anne is an individual health care provider with primary practice located at 2551 Greenwood Rd Ste 320 , Shreveport LA 71103-3989. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as her primary health care specialty. Wilden, Jessica Anne can be contacted via phone (182) 127-1763.Contact Information
Primary practice address
2551 Greenwood Rd Ste 320
Shreveport LA 71103-3989
Phone: (182) 127-1763
Fax: (318) 212-8186
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | MT186916 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | MD.206396 | Louisiana |
Profile Details
| NPI number | 1962565127 |
|---|---|
| LBN Legal business name | Wilden, Jessica Anne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Jun 17th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962565127 | NPPES |
| Louisiana | MEDICAID | 2342053 |
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