Provider Demographics
NPI:1952042822
Name:ARMENTOR, JENNA NEUVILLE
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:NEUVILLE
Last Name:ARMENTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ANDRE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2159
Mailing Address - Country:US
Mailing Address - Phone:337-359-5711
Mailing Address - Fax:337-364-6094
Practice Address - Street 1:1100 ANDRE ST STE 301
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2159
Practice Address - Country:US
Practice Address - Phone:337-359-5711
Practice Address - Fax:337-364-6094
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA224725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily