Provider Demographics
NPI:1184034886
Name:BAYARD, JASON JUDE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:JUDE
Last Name:BAYARD
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 BANK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-3806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:411 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:LOREAUVILLE
Practice Address - State:LA
Practice Address - Zip Code:70552
Practice Address - Country:US
Practice Address - Phone:337-229-4214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily