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Individual

JENNIFER LAUREN WOMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4950 ESSEN LN STE 400, BATON ROUGE, LA 70809
(225) 765-5864
(225) 765-2013
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0011
(225) 765-9196

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200202
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1339385
LA
Enumeration date
11/11/2008
Last updated
05/21/2021
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