Provider Demographics
NPI:1487123709
Name:MALBRUE, JENNY BELLE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:BELLE
Last Name:MALBRUE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 MACARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:LA
Mailing Address - Zip Code:70584-6212
Mailing Address - Country:US
Mailing Address - Phone:337-662-3737
Mailing Address - Fax:
Practice Address - Street 1:311 MACARTHUR DR
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:LA
Practice Address - Zip Code:70584-6212
Practice Address - Country:US
Practice Address - Phone:337-662-3737
Practice Address - Fax:337-662-3636
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN045271163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)