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General NPI Number Information
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NPI Number | 1942931076
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Entity Type | Individual
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Provider Name | JAMIE LANCON APRN, CNM
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Gender | Female
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 803 S MORGAN AVE
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City | BROUSSARD
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State | LA
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Zip | 70518-4921
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Country | US
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Telephone | 337-453-4346
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Fax |
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Provider Business Mailing Address
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Address Line | 117 THRUSH LOOP
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City | LAFAYETTE
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State | LA
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Zip | 70508-6218
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Country | US
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Telephone | 337-258-2245
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 219429
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License Number State | LA
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