Provider Demographics
NPI:1518209543
Name:OLDS, JENNIFER JULIANNA (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JULIANNA
Last Name:OLDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JULIANNA
Other - Last Name:LOWE, KITCHING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10423 OLD HAMMOND HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8296
Mailing Address - Country:US
Mailing Address - Phone:225-923-0960
Mailing Address - Fax:
Practice Address - Street 1:10423 OLD HAMMOND HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8296
Practice Address - Country:US
Practice Address - Phone:225-923-0960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-16
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014032547207W00000X
CODR.0065541207W00000X
LA325395207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology