Provider Demographics
NPI:1124992151
Name:TAYLOR-PITZER, JENNIFER LANE (FPSS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LANE
Last Name:TAYLOR-PITZER
Suffix:
Gender:F
Credentials:FPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544B W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-4122
Mailing Address - Country:US
Mailing Address - Phone:337-275-7710
Mailing Address - Fax:
Practice Address - Street 1:720 SAINT JOHN ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6706
Practice Address - Country:US
Practice Address - Phone:337-237-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10041175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist