MEDICARE: JESSICA B KRAKER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	207193	LA

General Provider Information

NPI Number	:	1275660631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA B KRAKER MD

Provider Business Mailing Address
First Line	:	131 S ROBERTSON ST
Second Line	:	SUITE 1340
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2807
Country	:	US
Telephone Number	:	504-988-4564
Fax Number	:	504-988-9191

Provider Business Practice Location Address
First Line	:	131 S ROBERTSON ST
Second Line	:	SUITE 1340
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2807
Country	:	US
Telephone Number	:	504-988-4564
Fax Number	:	504-988-9191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/28/2015

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