Individual
DR. JENNIFER LYNN MIATECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8585 PICARDY AVE., MEDICAL TOWER 2, BATON ROUGE, LA 70808
(225) 819-1120
Mailing address
8585 PICARDY AVE # 2, BATON ROUGE, LA 70809-3748
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
329764
LA
208D00000X
General Practice Physician
329764
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
LA
Other
Enumeration date
09/21/2018
Last updated
01/19/2022
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