Provider Demographics
NPI:1972023703
Name:GAY, JO ANN
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:ANN
Last Name:GAY
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:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:BASILE
Mailing Address - State:LA
Mailing Address - Zip Code:70515-0146
Mailing Address - Country:US
Mailing Address - Phone:337-580-2605
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 146
Practice Address - Street 2:
Practice Address - City:BASILE
Practice Address - State:LA
Practice Address - Zip Code:70515-0146
Practice Address - Country:US
Practice Address - Phone:337-580-2605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator