Provider Demographics
NPI:1942535315
Name:GERMOND, JENNIFER SMITH (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SMITH
Last Name:GERMOND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8585 PICARDY AVE
Mailing Address - Street 2:SUITE 114 HMG PHYSICIANS LLC
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3679
Mailing Address - Country:US
Mailing Address - Phone:225-819-1130
Mailing Address - Fax:225-763-4617
Practice Address - Street 1:8585 PICARDY AVE
Practice Address - Street 2:SUITE 114 HMG PHYSICIANS LLC
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3679
Practice Address - Country:US
Practice Address - Phone:225-819-1130
Practice Address - Fax:225-763-4617
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN074369AP05258363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1813036Medicaid
LA36555OtherLOUISIANA CDS LICENSE
MG1959393OtherFEDERAL DEA
249748YJ0HMedicare PIN
MG1959393OtherFEDERAL DEA