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General NPI Number Information
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NPI Number | 1508789421
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Entity Type | Organization
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Legal Business Name | WEST JEFFERSON MEDICAL CENTER
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 1111 MEDICAL CENTER BLVD
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City | MARRERO
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State | LA
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Zip | 70072-3151
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Country | US
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Telephone | 504-349-1570
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Fax | 504-349-1448
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Provider Business Mailing Address
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Address Line | 1111 MEDICAL CENTER BLVD
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City | MARRERO
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State | LA
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Zip | 70072-3151
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Country | US
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Telephone | 504-349-1570
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Fax | 504-349-1448
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Authorized Official
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Title or Position | FNP, INTERVENTIONAL RADIOLOGY
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Name | MS. NICOLE AUTIN CHIASSON
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Credential | FNP
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Telephone | 504-349-1570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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