Provider Demographics
NPI:1285895060
Name:PIKER, JENNIFER MENARD (PA-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:MENARD
Last Name:PIKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JOANNE
Other - Last Name:MENARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:309 SETTLERS TRACE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6061
Mailing Address - Country:US
Mailing Address - Phone:337-981-6065
Mailing Address - Fax:337-266-4775
Practice Address - Street 1:309 SETTLERS TRACE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6061
Practice Address - Country:US
Practice Address - Phone:337-981-6065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200200363AM0700X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA57545PA15Medicare PIN