Provider Demographics
NPI:1952944787
Name:BATISTE, JUQUILLA MILLER
Entity Type:Individual
Prefix:MRS
First Name:JUQUILLA
Middle Name:MILLER
Last Name:BATISTE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JUQUILLA
Other - Middle Name:RENEE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1058 E WORTHY ST STE B-2
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-4359
Mailing Address - Country:US
Mailing Address - Phone:225-450-3216
Mailing Address - Fax:225-450-3799
Practice Address - Street 1:1058 E WORTHY ST STE B-2
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4359
Practice Address - Country:US
Practice Address - Phone:225-450-3216
Practice Address - Fax:225-450-3799
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-24
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator