Basic Information
| Provider Information | |||||||||
| NPI: | 1598276198 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEARS | ||||||||
| FirstName: | JAZMAIGNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2404 FERRAND ST STE 24 | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712013233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183231560 | ||||||||
| FaxNumber: | 3183235682 | ||||||||
| Practice Location | |||||||||
| Address1: | 305 HOMER RD | ||||||||
| Address2: | |||||||||
| City: | MINDEN | ||||||||
| State: | LA | ||||||||
| PostalCode: | 710552833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186399562 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2017 | ||||||||
| LastUpdateDate: | 09/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 09/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.