MEDICARE: JEANNINE UTZMAN BABINEAUX FNP

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	363LF0000X	Family Nurse Practitioner	RN033154 A02178 PA	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	:	1790906493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNINE UTZMAN BABINEAUX FNP

Provider Business Mailing Address
First Line	:	320 ORCHARD DR
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-4446
Country	:	US
Telephone Number	:	337-474-8354
Fax Number	:

Provider Business Practice Location Address
First Line	:	2802 PINEVIEW ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70615-2063
Country	:	US
Telephone Number	:	337-497-0233
Fax Number	:	337-439-5029

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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