Healthcare Provider Details
I. General information
NPI: 1457679300
Provider Name (Legal Business Name): JENNIFER LASHAY ATKINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/16/2010
Last Update Date: 03/15/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
604 N ACADIA RD STE 100
THIBODAUX LA
70301-4897
US
IV. Provider business mailing address
604 N ACADIA RD STE 100
THIBODAUX LA
70301-4897
US
V. Phone/Fax
- Phone: 985-447-9045
- Fax:
- Phone: 985-447-9045
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 25924 |
| License Number State | MS |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME179267 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | W3332 |
| License Number State | TX |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 350254 |
| License Number State | LA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 070420 |
| License Number State | GA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 32527 |
| License Number State | AL |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 79686 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: