person
Gregor Jackson Dierks
Student in an Organized Health Care Education/Training Program in Shreveport, Louisiana
NPI 1265173678

Gregor Jackson Dierks is a Student in an Organized Health Care Education/Training Program based in Shreveport, LA. Gregor Jackson Dierks practices in Shreveport, LA. The NPI Number for Gregor Jackson Dierks is 1265173678 and holds a License No. (Louisiana).

The current practice location address for Gregor Jackson Dierks is 6051 Roma Dr Apt 609, Shreveport, LA and can be reached out via phone at 971-563-3919.

Location: 6051 Roma Dr Apt 609, Shreveport, LA, 71105-4671
person
Provider Profile Details
NPI Number
1265173678
Provider Name
Gregor Jackson Dierks
Credential
Provider Entity Type
Individual
Gender
Male
Address
6051 Roma Dr Apt 609, Shreveport, LA, 71105-4671
Phone Number
971-563-3919
Fax Number
Provider Enumeration Date
04/07/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
6051 Roma Dr Apt 609
City
State
Zip
71105-4671
Phone Number
971-563-3919
Fax Number
person
Provider Business Mailing Address Details
Address
6051 Roma Dr Apt 609
City
State
Zip
71105-4671
Phone Number
971-563-3919
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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