Individual
AMANDA JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1103 KALISTE SALOOM RD STE 304, LAFAYETTE, LA 70508-5784
(337) 988-5646
Mailing address
1103 KALISTE SALOOM RD STE 304, LAFAYETTE, LA 70508-5784
(337) 988-5646
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
203905
LA
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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