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Individual

BETHANY C JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP06168
LA
363L00000X
Nurse Practitioner
RN101516
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09607021
MS
05
2126369
LA
Enumeration date
08/18/2010
Last updated
03/16/2011
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