Individual
MRS. JESSICA LYNN LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2390 W CONGRESS STREET, UNIVERSITY MED CENTER, LAFAYETTE, LA 70596
(337) 261-6000
Mailing address
112 SUMMERTYME DRIVE, YOUNGSVILLE, LA 70592
(337) 856-0973
(337) 261-6585
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN100751
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1478890
—
LA
Enumeration date
08/29/2006
Last updated
07/08/2007
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