Individual
JEANIE TASSIN PONTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1587 N BOLTON AVE, ALEXANDRIA, LA 71303-4217
(318) 445-9823
Mailing address
1587 N BOLTON AVE, ALEXANDRIA, LA 71303-4217
(318) 445-9823
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08819
LA
Other
Enumeration date
06/15/2016
Last updated
08/25/2021
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