1528411337 NPI number — MS. JENNIFER ELIZABETH ALLAIN APRN

Table of content: MS. JENNIFER ELIZABETH ALLAIN APRN (NPI 1528411337)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528411337 NPI number — MS. JENNIFER ELIZABETH ALLAIN APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLAIN
Provider First Name:
JENNIFER
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528411337
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
112 LAGUNA LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70508-7070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-254-8760
Provider Business Mailing Address Fax Number:
770-723-8553

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 LAGUNA LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70508-7070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-254-8760
Provider Business Practice Location Address Fax Number:
770-723-8553
Provider Enumeration Date:
07/16/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP08880 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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