Provider Demographics
NPI:1659820181
Name:CREECH, JENNIFER HEAUSLER (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:HEAUSLER
Last Name:CREECH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-4605
Mailing Address - Country:US
Mailing Address - Phone:504-575-3712
Mailing Address - Fax:504-575-3691
Practice Address - Street 1:2807 S COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-7915
Practice Address - Country:US
Practice Address - Phone:985-730-7310
Practice Address - Fax:985-730-7391
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily