Provider Demographics
NPI:1780211607
Name:ROY, JENNIFER STEVENSON (FNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:STEVENSON
Last Name:ROY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 S TYLER ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-2353
Mailing Address - Country:US
Mailing Address - Phone:985-892-9143
Mailing Address - Fax:985-892-9656
Practice Address - Street 1:1203 S TYLER ST STE 200
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-2353
Practice Address - Country:US
Practice Address - Phone:985-892-9143
Practice Address - Fax:985-892-9656
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA212082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily