Provider Demographics
NPI:1669108098
Name:LOUP, EMILY JANELLE (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JANELLE
Last Name:LOUP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9876 LOBLOLLY PINES LN
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-5836
Mailing Address - Country:US
Mailing Address - Phone:225-936-3847
Mailing Address - Fax:
Practice Address - Street 1:9688 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-1110
Practice Address - Country:US
Practice Address - Phone:225-408-7587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant