Provider Demographics
NPI:1477523959
Name:WHITEHEAD, JONI DIANNE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:DIANNE
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:JONI
Other - Middle Name:DIANNE
Other - Last Name:LAMPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:567 WALKER ST
Mailing Address - Street 2:
Mailing Address - City:MERRYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70653-3040
Mailing Address - Country:US
Mailing Address - Phone:337-825-1728
Mailing Address - Fax:337-825-1229
Practice Address - Street 1:567 WALKER ST
Practice Address - Street 2:
Practice Address - City:MERRYVILLE
Practice Address - State:LA
Practice Address - Zip Code:70653-3040
Practice Address - Country:US
Practice Address - Phone:337-825-1728
Practice Address - Fax:337-825-1229
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA78494-3569363LF0000X
TX673697363LF0000X
LAAP03569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1432385Medicaid
8N8278OtherBLUE CROSS/BLUE SHIELD
P00117217OtherRAILROAD MEDICARE
TX172875001Medicaid
8N8278OtherBLUE CROSS/BLUE SHIELD
LA1432385Medicaid