Provider Demographics
NPI:1912694993
Name:MAY, JANSSEN (LAT, ATC, NREMT-EMR)
Entity Type:Individual
Prefix:MR
First Name:JANSSEN
Middle Name:
Last Name:MAY
Suffix:
Gender:M
Credentials:LAT, ATC, NREMT-EMR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 HOWARD BROWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-0288
Mailing Address - Country:US
Mailing Address - Phone:318-372-6816
Mailing Address - Fax:
Practice Address - Street 1:4061 CAPLES RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71292-1206
Practice Address - Country:US
Practice Address - Phone:318-249-2117
Practice Address - Fax:318-249-4774
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.J003162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer