Individual
MRS. JENNIFER WILSON ASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1717 OAK PARK BLVD, 3RD FLOOR, LAKE CHARLES, LA 70601-8991
(337) 494-4915
(337) 494-4936
Mailing address
1435 S CHATEAU CIR, LAKE CHARLES, LA 70605-1341
(337) 474-9282
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
990695
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
990695
LPN STATE LICENSE #
LA
Enumeration date
07/27/2006
Last updated
07/08/2007
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