Provider Demographics
NPI:1790517704
Name:HOLLEY, JENNIFER BATROUS
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BATROUS
Last Name:HOLLEY
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 1:12339 OAK FIELDS DR
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3170
Mailing Address - Country:US
Mailing Address - Phone:225-279-6310
Mailing Address - Fax:
Practice Address - Street 1:12339 OAK FIELDS DR
Practice Address - Street 2:
Practice Address - City:GEISMAR
Practice Address - State:LA
Practice Address - Zip Code:70734-3170
Practice Address - Country:US
Practice Address - Phone:225-279-6310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-17
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN146013163W00000X
LACNP239730363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse