Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK SUTTON FENNER
Active Sole ProprietorJACK SUTTON FENNER is a Athletic Trainer healthcare provider located in SHREVEPORT, Louisiana. NPI 1205629672 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · SHREVEPORT, LA
Registration Details
- NPI Number
- 1205629672
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 27, 2025 (1.1763579977184 yrs)
- Last Updated
- May 27, 2025
- License
-
012122580 (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
427 PRESTONWOOD DRSHREVEPORT, LA, 711153723Browse LA providers · Browse ZIP 71115
- Phone
- 3183443686
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in SHREVEPORT, LA
| Name | Credential | NPI |
|---|---|---|
| BRIAN DAVID ROCKETT | ATC, LATH | 1992945810 |
| JOSHUA COX | — | 1659762813 |
| LAQUEISHA NAQUAE WILLIAMS | — | 1184197188 |
| JENNIFER FOGLEMAN | — | 1154934974 |
| MEGHAN ELIZABETH NEFFENDORF | MS,ATC,LAT | 1932923109 |
| HALLIE LITTLE | LAT, ATC | 1174332019 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.