Individual
JENNA TRAYLOR ORTEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMSC, PA
Contact information
Practice address
7777 HENNESSY BLVD, BATON ROUGE, LA 70808-4300
(225) 765-7163
Mailing address
8230 SUMMA AVE STE C, BATON ROUGE, LA 70809-3465
(225) 757-0552
(225) 763-9997
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200192
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1190268
—
LA
Enumeration date
07/11/2008
Last updated
05/31/2023
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