Provider Demographics
NPI:1063076586
Name:CHU, JESSICA THUY LINH (PA-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:THUY LINH
Last Name:CHU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5630 READ BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-3106
Mailing Address - Country:US
Mailing Address - Phone:504-248-5357
Mailing Address - Fax:
Practice Address - Street 1:5630 READ BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3106
Practice Address - Country:US
Practice Address - Phone:504-248-5357
Practice Address - Fax:504-248-5377
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA325769363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1N2499Medicaid