Provider Demographics
NPI:1891224192
Name:HARRELL-MOHAMED, JAKAYLA MARIE (MD)
Entity Type:Individual
Prefix:MRS
First Name:JAKAYLA
Middle Name:MARIE
Last Name:HARRELL-MOHAMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAKAYLA
Other - Middle Name:MARIE
Other - Last Name:HARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 CABERNET DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-1135
Mailing Address - Country:US
Mailing Address - Phone:601-341-7247
Mailing Address - Fax:
Practice Address - Street 1:21 CABERNET DR
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-1135
Practice Address - Country:US
Practice Address - Phone:601-341-7247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330710207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology