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Individual

DR. JENNA MARTIN BOURGEOIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
8777 BLUEBONNET BLVD, SUITE A, BATON ROUGE, LA 70810-2975
(225) 432-0000
(225) 766-1995
Mailing address
8777 BLUEBONNET BLVD, SUITE A, BATON ROUGE, LA 70810-2975
(225) 432-0000
(225) 766-1995

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
304332
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2441574
LA
Enumeration date
04/10/2011
Last updated
10/06/2021
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