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NPI Code Detail

MEDICARE: MISS JENNIFER MICHELLE BLOCK

MEDICARE: MISS JENNIFER MICHELLE BLOCK
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
1363AS0400XSurgical Physician AssistantPA.200100LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770689333
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER MICHELLE BLOCK
Provider Business Mailing Address
First Line : 10101 PARK ROWE AVE STE 200
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-1685
Country : US
Telephone Number : 225-769-2200
Fax Number : 225-768-2185
Provider Business Practice Location Address
First Line : 10101 PARK ROWE AVE STE 200
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-1685
Country : US
Telephone Number : 225-769-2200
Fax Number : 225-768-2185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 09/19/2007

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Directions to “ MISS JENNIFER MICHELLE BLOCK ” Practice Location

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