Provider Demographics
NPI:1649673161
Name:PRANKIENAS, JESSICA (APRN, CNM)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:PRANKIENAS
Suffix:
Gender:
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48184 MORRIS RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-3702
Mailing Address - Country:US
Mailing Address - Phone:210-516-2485
Mailing Address - Fax:
Practice Address - Street 1:48184 MORRIS RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-3702
Practice Address - Country:US
Practice Address - Phone:210-516-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224810164W00000X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No164W00000XNursing Service ProvidersLicensed Practical Nurse