Healthcare Provider Details

I. General information

NPI: 1982112462
Provider Name (Legal Business Name): JAZMIN ESCALANTE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 07/03/2020
Certification Date: 07/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 N MORRISON BLVD STE 125
HAMMOND LA
70401-2242
US

IV. Provider business mailing address

1320 N MORRISON BLVD STE 125
HAMMOND LA
70401
US

V. Phone/Fax

Practice location:
  • Phone: 985-402-3762
  • Fax: 985-256-2591
Mailing address:
  • Phone: 985-402-3762
  • Fax: 985-256-2591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP09627
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: