Provider Demographics
NPI:1750176046
Name:HOLLOWAY, JESEKA MONISE
Entity type:Individual
Prefix:
First Name:JESEKA
Middle Name:MONISE
Last Name:HOLLOWAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 RUE DE LAPLACE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-4560
Mailing Address - Country:US
Mailing Address - Phone:562-481-8752
Mailing Address - Fax:
Practice Address - Street 1:537 RUE DE LAPLACE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-4560
Practice Address - Country:US
Practice Address - Phone:562-481-8752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No374J00000XNursing Service Related ProvidersDoula