| Choudrant Primary Care Llc | |
|
3845 Elm St Ste 3 Choudrant LA 71227-3017 | |
| (318) 695-9200 | |
| Not Available |
| Full Name | Choudrant Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3845 Elm St Ste 3, Choudrant, Louisiana |
| Authorized Official Name and Position | Jennifer S. Juneau (OWNER) |
| Authorized Official Contact | 3186959200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Choudrant Primary Care Llc 216 Loblolly Ln Choudrant LA 71227-4804 Ph: () - | Choudrant Primary Care Llc 3845 Elm St Ste 3 Choudrant LA 71227-3017 Ph: (318) 695-9200 |
| NPI Number | 1962267922 |
|---|---|
| Provider Enumeration Date | 02/19/2024 |
| Last Update Date | 09/20/2024 |
| Medicare PECOS PAC ID | 1052757416 |
|---|---|
| Medicare Enrollment ID | O20240308000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962267922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Jennifer S Juneau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285981068 PECOS PAC ID: 3072737345 Enrollment ID: I20140609000277 |
| Provider Name | Emily M Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255146585 PECOS PAC ID: 6305363383 Enrollment ID: I20250505001183 |