MEDICARE: AMBER LEA JEANSONNE ACNPC

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
1	363LA2100X	Acute Care Nurse Practitioner	AP06563	LA

General Provider Information

NPI Number	:	1952699514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LEA JEANSONNE ACNPC

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD STE 107
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-765-5864
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	7777 HENNESSY BLVD STE 409
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4365
Country	:	US
Telephone Number	:	225-765-5864
Fax Number	:	225-765-2013

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2011
Last Update Date	:	03/12/2026

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