Healthcare Provider Details

I. General information

NPI: 1013210400
Provider Name (Legal Business Name): JENNIFER DUPUY PONTTI RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8080 BLUEBONNET BLVD SUITE 1000
BATON ROUGE LA
70810-7827
US

IV. Provider business mailing address

8080 BLUEBONNET BLVD STE 1000
BATON ROUGE LA
70810-7827
US

V. Phone/Fax

Practice location:
  • Phone: 225-924-2424
  • Fax: 225-408-7984
Mailing address:
  • Phone: 225-924-2424
  • Fax: 225-408-7980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN100040
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN100040
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: