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Individual

MRS. JENNIFER LOVE BRASUELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
79630 HIGHWAY 21, BUSH, LA 70431
(985) 730-2252
(985) 730-2258
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(985) 730-2252
(225) 765-9196

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200233
LA
363A00000X
Physician Assistant
PA.TPA.642
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2163892
LA
Enumeration date
10/30/2008
Last updated
03/26/2025
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