Provider Demographics
NPI:1225291230
Name:JOCHUM, TARA WHITTAKER (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:WHITTAKER
Last Name:JOCHUM
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:WHITTAKER
Other - Last Name:DODD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FP-C
Mailing Address - Street 1:3838 N CAUSEWAY BLVD STE 2200
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-8306
Mailing Address - Country:US
Mailing Address - Phone:504-849-4500
Mailing Address - Fax:
Practice Address - Street 1:1850 GAUSE BLVD E
Practice Address - Street 2:ST 101
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5442
Practice Address - Country:US
Practice Address - Phone:985-634-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2015-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily