Individual
JILL ANGELLE BREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
1322 ELTON RD, SUITE F, JENNINGS, LA 70546-4100
(337) 824-8868
(337) 824-8840
Mailing address
1322 ELTON RD, SUITE F, JENNINGS, LA 70546-4100
(337) 824-8868
(337) 824-8840
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
07103
LA
363LP2300X
Primary Care Nurse Practitioner
Primary
07103
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2327500
—
LA
Enumeration date
11/06/2012
Last updated
07/06/2020
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