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Individual

MRS. JENNIFER LANE GILLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
4429 CLARA STREET, NEW ORLEANS, LA 70115
(504) 842-5300
(504) 779-5528
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
(504) 779-5528

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06960
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05431857
MS
05
2323849
LA
Enumeration date
07/25/2012
Last updated
04/28/2014
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