Healthcare Provider Details

I. General information

NPI: 1619700853
Provider Name (Legal Business Name): CELINE JEHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15795 PAUL VEGA MD DRIVE
HAMMOND LA
70403
US

IV. Provider business mailing address

15795 PAUL VEGA MD DRIVE
HAMMOND LA
70403
US

V. Phone/Fax

Practice location:
  • Phone: 985-230-7525
  • Fax: 985-230-3656
Mailing address:
  • Phone: 985-230-7525
  • Fax: 985-230-3656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number220633
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: