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General NPI Number Information
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NPI Number | 1790714988
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Entity Type | Individual
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Provider Name | JENNIFER M LEMOINE APRN NNP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 107 MONTROSE AVE SUITE D
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City | LAFAYETTE
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State | LA
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Zip | 70503-3852
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Country | US
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Telephone | 337-981-9316
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Fax | 337-981-8303
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Provider Business Mailing Address
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Address Line | 908 BROADMOOR BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70503-5004
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Country | US
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Telephone | 337-504-4411
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | AP04670
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License Number State | LA
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