Healthcare Provider Details

I. General information

NPI: 1851492953
Provider Name (Legal Business Name): JESSICA LAUREN MAGRO AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 03/15/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3149 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506-7209
US

IV. Provider business mailing address

3149 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506-7209
US

V. Phone/Fax

Practice location:
  • Phone: 337-706-3415
  • Fax: 337-706-3460
Mailing address:
  • Phone: 337-706-3415
  • Fax: 337-706-3460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: