MEDICARE: LISA ANN JAUBERT ANP-C

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	363LA2200X	Adult Health Nurse Practitioner	RN066949 AP05153	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1780703710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA ANN JAUBERT ANP-C

Provider Business Mailing Address
First Line	:	2621 NORTH DR
Second Line	:	SUITE B
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-4042
Country	:	US
Telephone Number	:	337-898-1860
Fax Number	:	337-898-1862

Provider Business Practice Location Address
First Line	:	2621 NORTH DR
Second Line	:	SUITE B
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-4042
Country	:	US
Telephone Number	:	337-898-1860
Fax Number	:	337-898-1862

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	12/17/2009

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