Provider Demographics
NPI:1114367232
Name:WAKEFIELD, JENNIFER S
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:WAKEFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 HICKCOCK DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70811-4513
Mailing Address - Country:US
Mailing Address - Phone:480-221-5868
Mailing Address - Fax:
Practice Address - Street 1:8405 HICKCOCK DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70811-4513
Practice Address - Country:US
Practice Address - Phone:480-221-5868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula