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Individual

MRS. JALISA MARIE DYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP

Contact information

Practice address
3140 FLORIDA ST, BATON ROUGE, LA 70806-3757
(225) 650-2000
Mailing address
1645 GLENEAGLES BND, ZACHARY, LA 70791-5447
(601) 620-8303

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
903301
MS
363LW0102X
Women's Health Nurse Practitioner
Primary
214139
LA
363LW0102X
Women's Health Nurse Practitioner
903301
MS

Other

Enumeration date
04/19/2019
Last updated
03/17/2025
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