Healthcare Provider Details

I. General information

NPI: 1427329929
Provider Name (Legal Business Name): JENNIFER M WATSON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2012
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13702 COURSEY BLVD STE 10B
BATON ROUGE LA
70817-1370
US

IV. Provider business mailing address

6723 JEFFERSON HWY
BATON ROUGE LA
70806-8106
US

V. Phone/Fax

Practice location:
  • Phone: 225-364-3915
  • Fax:
Mailing address:
  • Phone: 225-926-2400
  • Fax: 225-926-2470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLA 05212
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: