Tyson, Patrice Jenne
Tyson, Patrice Jenne is an individual health care provider with primary practice located at 7777 Hennessy Blvd Suite 409, Baton Rouge LA 70808-4300. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is her primary health care specialty. Tyson, Patrice Jenne can be contacted via phone (225) 765-6834.Contact Information
Primary practice address
7777 Hennessy Blvd Suite 409
Baton Rouge LA 70808-4300
Phone: (225) 765-6834
Fax: (225) 765-2054
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35090026 | Ohio |
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | MD.025783 | Louisiana |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD.025783 | Louisiana |
Profile Details
| NPI number | 1558569764 |
|---|---|
| LBN Legal business name | Tyson, Patrice Jenne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2007 |
| Last updated | Oct 25th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558569764 | NPPES |
| Louisiana | MEDICAID | 1044121 | |
| Louisiana | Other | 000000530761 | |
| Louisiana | Other | 000000225140 | |
| Louisiana | Other | 415048 | |
| Louisiana | Other | 749095 | |
| Louisiana | MEDICAID | 2745551 | |
| Louisiana | Other | 962065 | |
| Louisiana | MEDICAID | 03659802 | |
| Louisiana | Other | 1021891110001 |
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