Provider Demographics
NPI:1659594661
Name:HERNANDEZ, JAMIE AUTHEMENT (APRN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:AUTHEMENT
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 PICKETT AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3900
Mailing Address - Country:US
Mailing Address - Phone:225-343-8047
Mailing Address - Fax:985-230-6653
Practice Address - Street 1:9050 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4103
Practice Address - Country:US
Practice Address - Phone:225-928-2555
Practice Address - Fax:225-929-9685
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05178363LN0000X
LARN105300163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Not Answered163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care