Provider Demographics
NPI:1285098079
Name:BLANDING HOOPER, JESSICA DENISE (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:DENISE
Last Name:BLANDING HOOPER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:LA
Mailing Address - Zip Code:70584-1258
Mailing Address - Country:US
Mailing Address - Phone:323-497-4014
Mailing Address - Fax:
Practice Address - Street 1:3975 I 49 S SERVICE RD STE 201
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-0775
Practice Address - Country:US
Practice Address - Phone:337-407-2795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA312600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2508971Medicaid