Healthcare Provider Details

I. General information

NPI: 1518833243
Provider Name (Legal Business Name): JAZZALYN WHITMORE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3844 PENSACOLA DR
BATON ROUGE LA
70814-7164
US

IV. Provider business mailing address

3844 PENSACOLA DR
BATON ROUGE LA
70814-7164
US

V. Phone/Fax

Practice location:
  • Phone: 225-313-0711
  • Fax:
Mailing address:
  • Phone: 225-313-0711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number025883
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: