Healthcare Provider Details

I. General information

NPI: 1831910124
Provider Name (Legal Business Name): JESSICA KLUMPP LAZZARA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 LAPALCO BLVD STE 2B
HARVEY LA
70058-2326
US

IV. Provider business mailing address

3820 LAPALCO BLVD STE 2B
HARVEY LA
70058-2326
US

V. Phone/Fax

Practice location:
  • Phone: 504-358-4915
  • Fax: 504-949-0466
Mailing address:
  • Phone: 504-358-4915
  • Fax: 504-949-0466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number237704
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: