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Individual

JACOB DWAYNE LABATUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8585 PICARDY AVE STE 110, BATON ROUGE, LA 70809-3749
(225) 767-0822
(225) 769-5424
Mailing address
39438 HIGHWAY 929, PRAIRIEVILLE, LA 70769-4927
(225) 323-3999

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN154204
LA
363L00000X
Nurse Practitioner
Primary
226191
LA

Other

Enumeration date
06/01/2022
Last updated
05/28/2024
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