Provider Demographics
NPI:1134245582
Name:POWELL, JODI TOEPFER (APRN)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:TOEPFER
Last Name:POWELL
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 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:985-730-2252
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:79630 HIGHWAY LA 21
Practice Address - Street 2:
Practice Address - City:BUSH
Practice Address - State:LA
Practice Address - Zip Code:70431
Practice Address - Country:US
Practice Address - Phone:985-730-2252
Practice Address - Fax:985-730-2258
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05031363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care