Provider Demographics
NPI:1982767810
Name:SHANK, JESSICA J (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:J
Last Name:SHANK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-610-7119
Mailing Address - Fax:504-988-2943
Practice Address - Street 1:150 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-988-6300
Practice Address - Fax:504-988-7473
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2018-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA308640207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology