Provider Demographics
NPI:1164854360
Name:JEMISON, ROBERT J (APRN, FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:JEMISON
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7506 JONLEE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-1435
Mailing Address - Country:US
Mailing Address - Phone:504-388-3146
Mailing Address - Fax:504-872-9100
Practice Address - Street 1:7506 JONLEE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-1435
Practice Address - Country:US
Practice Address - Phone:504-388-3146
Practice Address - Fax:504-872-9100
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LATAP003201364SF0001X
LAAP07502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2350242Medicaid
MS01403772Medicaid
LA321130YH3UMedicare PIN