Individual
JENNIFER YVONNE TREADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95015720
CA
363LP0200X
Pediatric Nurse Practitioner
AP06244
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2336037
—
LA
01
—
292348YH54
MEDICARE - PTAN
LA
Enumeration date
04/24/2013
Last updated
01/10/2024
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