Provider Demographics
NPI:1659721702
Name:KU, JESSICA R (NP-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:R
Last Name:KU
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:R
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3000 MAGAZINE ST
Mailing Address - Street 2:APT 302
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2252
Mailing Address - Country:US
Mailing Address - Phone:337-831-2071
Mailing Address - Fax:
Practice Address - Street 1:3700 SAINT CHARLES AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-4637
Practice Address - Country:US
Practice Address - Phone:504-229-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily