Provider Demographics
NPI:1134781172
Name:POCHE, JENNIFER RHONDA (NP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RHONDA
Last Name:POCHE
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 1:711 BOCAGE LN
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-1607
Mailing Address - Country:US
Mailing Address - Phone:504-782-0541
Mailing Address - Fax:
Practice Address - Street 1:711 BOCAGE LN
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-1607
Practice Address - Country:US
Practice Address - Phone:504-782-0541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-29
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0000000000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner