Provider Demographics
NPI:1073533568
Name:DUMESTRE, JEANNE (APRN, BC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:DUMESTRE
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 S PRIEUR ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-5126
Mailing Address - Country:US
Mailing Address - Phone:504-931-0538
Mailing Address - Fax:
Practice Address - Street 1:4300 S PRIEUR ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-5126
Practice Address - Country:US
Practice Address - Phone:504-931-0538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47422163W00000X
MS878594163W00000X
LAAP02080363LF0000X
MS901644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1168547Medicaid
LA355022YH58Medicare UPIN
LA68547Medicaid