Provider Demographics
NPI:1780316182
Name:THOMPSON, JENNIFER HERNANDEZ (LCCE, CVD, APPAC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:HERNANDEZ
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCCE, CVD, APPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 KIM DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3925
Mailing Address - Country:US
Mailing Address - Phone:337-591-5781
Mailing Address - Fax:
Practice Address - Street 1:4600 AMBASSADOR CAFFREY PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-470-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-26
Last Update Date:2022-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA174H00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
No174H00000XOther Service ProvidersHealth Educator