Individual
CRYSTAL WHITE JEANSONNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1105 KALISTE SALOOM RD, LAFAYETTE, LA 70508-5705
(337) 470-1058
(337) 470-0047
Mailing address
1105 KALISTE SALOOM ROAD, LAFAYETTE, LA 70508
(337) 470-1058
(337) 470-0047
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08664
LA
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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