Individual
JESSICA FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
816 PARK AVE, OPELOUSAS, LA 70570-4174
(337) 446-3530
Mailing address
816 PARK AVE, OPELOUSAS, LA 70570-4174
(337) 446-3530
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88-1074626
—
LA
Enumeration date
03/15/2022
Last updated
03/17/2022
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