Provider Demographics
NPI:1851115349
Name:LETHERMON, JO'QUISHIA AYOI (DNP, WHNP-BC, CNM)
Entity type:Individual
Prefix:
First Name:JO'QUISHIA
Middle Name:AYOI
Last Name:LETHERMON
Suffix:
Gender:F
Credentials:DNP, WHNP-BC, CNM
Other - Prefix:
Other - First Name:JO
Other - Middle Name:
Other - Last Name:LETHERMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, WHNP-BC, CNM
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:337-470-5239
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:4630 AMBASSADOR CAFFERY PKWY STE 206
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6949
Practice Address - Country:US
Practice Address - Phone:337-470-5239
Practice Address - Fax:225-765-9886
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA238012207V00000X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology