Provider Demographics
NPI:1669685871
Name:DUNLAP, JENNIFER THERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:THERESA
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 NAPOLEON AVE
Mailing Address - Street 2:SUITE 805
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6357
Mailing Address - Country:US
Mailing Address - Phone:504-301-4991
Mailing Address - Fax:
Practice Address - Street 1:2633 NAPOLEON AVE
Practice Address - Street 2:SUITE 805
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6357
Practice Address - Country:US
Practice Address - Phone:504-301-4991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA257992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1046477Medicaid
LA4F742Medicare ID - Type Unspecified