Individual
JEAN GENZALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16070 DOCTORS BLVD, HAMMOND, LA 70403-1478
(985) 230-7350
(985) 230-7351
Mailing address
675 N CAUSEWAY BLVD, MANDEVILLE, LA 70448-4600
(985) 200-3530
(985) 202-2010
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP05722
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1466255
—
LA
01
—
P00757861
MEDICARE RR
LA
Enumeration date
02/26/2009
Last updated
09/13/2022
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