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Individual

JODIE MARIE ROTH LAFEUILLADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, CPNP-AC

Contact information

Practice address
901 W 38TH ST STE 410, AUSTIN, TX 78705-1162
(512) 992-1378
(512) 992-1379
Mailing address
901 W 38TH ST STE 410, AUSTIN, TX 78705-1162
(512) 992-1378
(512) 992-1379

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
740243
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
740243
TX
363LP0222X
Critical Care Pediatric Nurse Practitioner
740243
TX

Other

Enumeration date
04/06/2007
Last updated
01/10/2025
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