Healthcare Provider Details

I. General information

NPI: 1790604189
Provider Name (Legal Business Name): SARAH JONES RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SENATOR PICARD DR
MAURICE LA
70555-3781
US

IV. Provider business mailing address

110 SENATOR PICARD DR
MAURICE LA
70555-3781
US

V. Phone/Fax

Practice location:
  • Phone: 337-417-0479
  • Fax: 337-385-3282
Mailing address:
  • Phone: 337-417-0479
  • Fax: 337-385-3282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number353416
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: