Provider Demographics
NPI:1851530810
Name:REYES, JAMIE P (APRN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:P
Last Name:REYES
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 1:4315 HOUMA BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2940
Mailing Address - Country:US
Mailing Address - Phone:504-885-8563
Mailing Address - Fax:504-455-1072
Practice Address - Street 1:4315 HOUMA BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2940
Practice Address - Country:US
Practice Address - Phone:504-885-8563
Practice Address - Fax:504-455-1072
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2046363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
REY104343132OtherNATIONAL CERTIFICATION CORPORATION
LARN110162-AP05854OtherSTATE BOARD OF NURSING