person
Mr. Jackie Wayne Etheridge, APRN,APMHNP
Psychiatric/Mental Health Nurse Practitioner in Pineville, Louisiana
NPI 1740515790

Jackie Wayne Etheridge is a Psychiatric/Mental Health Nurse Practitioner based in Alexandria, LA and is specialized in Psychiatric/Mental Health. Jackie Wayne Etheridge practices in Pineville, LA and has the professional credentials of APRN,APMHNP. The NPI Number for Jackie Wayne Etheridge is 1740515790 and holds a License No. AP05657 (Louisiana).

The current practice location address for Jackie Wayne Etheridge is 242 West Shamrock, Unit 1, Pineville, LA and can be reached out via phone at 318-484-6850.

Location: 242 West Shamrock, Unit 1, Pineville, LA, 71306-7473
person
Provider Profile Details
NPI Number
1740515790
Provider Name
Jackie Wayne Etheridge
Credential
APRN,APMHNP
Provider Entity Type
Individual
Gender
Male
Address
242 West Shamrock, Unit 1, Pineville, LA, 71306-7473
Phone Number
318-484-6850
Fax Number
Provider Enumeration Date
10/08/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
242 West Shamrock, Unit 1
City
State
Zip
71360
Phone Number
318-484-6850
Fax Number
person
Provider Business Mailing Address Details
Address
242 West Shamrock, Unit 1
City
State
Zip
71360
Phone Number
318-484-6850
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
AP05657 (Louisiana)
Definition
Definition to come...
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