Individual
JESSICA BOSCH BORDELON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
15799 PROFESSIONAL PLZ, HAMMOND, LA 70403-1452
(985) 419-0025
(985) 419-0035
Mailing address
15799 PROFESSIONAL PLZ, HAMMOND, LA 70403-1452
(985) 419-0025
(985) 419-0035
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP06791
LA
363LA2200X
Adult Health Nurse Practitioner
AP06791
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2190857
—
LA
Enumeration date
03/12/2012
Last updated
12/09/2025
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