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NPI Code Detail

MEDICARE: JUDY ANNE JAMESON RN, MSN, C-FNP

MEDICARE: JUDY ANNE JAMESON RN, MSN, C-FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner655243327LA
2363LF0000XFamily Nurse Practitioner655243327LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1020232OTHERLADRUG ID#
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497752018
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY ANNE JAMESON RN, MSN, C-FNP
Provider Business Mailing Address
First Line : 85 JOE ROSIER RD
Second Line :
City : DEVILLE
State : LA
Zip : 71328-9027
Country : US
Telephone Number : 318-466-3649
Fax Number : 318-466-5803
Provider Business Practice Location Address
First Line : 2495 SHREVEPORT HWY
Second Line :
City : PINEVILLE
State : LA
Zip : 71360-4044
Country : US
Telephone Number : 318-473-0010
Fax Number : 318-483-5202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2005
Last Update Date : 09/11/2023

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