Individual
JARED R WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.P.R.N.
Contact information
Practice address
1727 IMPERIAL BLVD, BLDG 2, LAKE CHARLES, LA 70605-5362
(337) 310-3670
(337) 421-1443
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8258
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP06501
LA
Other
Enumeration date
07/14/2011
Last updated
04/13/2017
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