Individual
JENNIE LYNN DEDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3600 FLORIDA BLVD, BATON ROUGE, LA 70806-3842
(225) 767-4673
Mailing address
3600 FLORIDA BLVD, BATON ROUGE, LA 70806-3842
(225) 767-4673
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06959
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2346865
—
LA
Enumeration date
11/15/2012
Last updated
01/16/2020
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