Jessica Spears, | |
6450 Louisiana Highway 1, Innis, LA 70747-4700 | |
(225) 492-3775 | |
(225) 492-3782 |
Full Name | Jessica Spears |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 6450 Louisiana Highway 1, Innis, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164817078 | NPI | - | NPPES |
2396102 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | RN118313 (Louisiana) | Secondary |
363LF0000X | Nurse Practitioner - Family | AP08282 (Louisiana) | Primary |
Entity Name | Innis Community Health Center, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205858388 PECOS PAC ID: 9931130358 Enrollment ID: O20050825000691 |
Mailing Address | Practice Location Address |
---|---|
Jessica Spears, 6450 Louisiana Highway 1, Batchelor, LA 70715-3212 Ph: (225) 492-3775 | Jessica Spears, 6450 Louisiana Highway 1, Innis, LA 70747-4700 Ph: (225) 492-3775 |
Latasha L Johnigan, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6450 Louisiana Highway 1, Suite B, Innis, LA 70747 Phone: 225-492-3775 Fax: 225-492-3782 | |
Mrs. Ahlecia Nicole Haney, F.N.P Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6450 La Highway 1, Innis, LA 70747 Phone: 225-492-3775 Fax: 225-492-3782 |