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Organization
SOUTHEAST FAMILY MEDICAL PRACTICE
Active
Organization
SOUTHEAST FAMILY MEDICAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAZMIN ESCALANTE (NURSE PRACTITIONER)
(985) 402-3762
Entity
Organization
Contact information
Practice address
1320 N MORRISON BLVD STE 125, HAMMOND, LA 70401-2242
(985) 402-3762
(985) 256-2591
Mailing address
1320 N MORRISON BLVD STE 125, HAMMOND, LA 70401-2242
(985) 402-3762
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
02/25/2020
Last updated
05/05/2020
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