Healthcare Provider Details
I. General information
NPI: 1447813712
Provider Name (Legal Business Name): JASMIN JULIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/22/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5850 FLORIDA BLVD
BATON ROUGE LA
70806-4247
US
IV. Provider business mailing address
9441 COMMON ST STE B
BATON ROUGE LA
70809-1463
US
V. Phone/Fax
- Phone: 225-201-0696
- Fax:
- Phone: 225-923-3733
- Fax: 225-923-3735
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: