JACQUELINE CASEY CROUCH (NPI# 1295373025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295373025 |
| Entity Type | Individual |
| Full Name | JACQUELINE CASEY CROUCH |
| Practice Address |
North Stadium Drive Athletics Administration Building Baton Rouge LA 70803-0001 |
| Mailing Address |
9051 Eastlake Ave Baton Rouge LA 70810-0404 |
| Practice Telephone | 2255782050 |
| Practice Fax Number | 3924225578 |
| Mailing Telephone | 2256108875 |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2019-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
NORTH STADIUM DRIVE ATHLETICS ADMINISTRATION BUILDING |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70803-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649822164 | Joshua Vaughn Bunch | Specialist/Technologist | Lsu Athletic Department, Athletic Training, North Stadium Drive, Baton Rouge, LA 70803 | 2019-07-15 |
| 1225512767 | Louisiana State University | Pharmacy | 1 North Stadium Drive, Broussard Center for Athletic Training, Baton Rouge, LA 70803 | 2018-09-20 |
| 1447652433 | Joshua Pratt | Specialist/Technologist | Lsu Athletic Training, Athletic Administration Building, Baton Rouge, LA 70803 | 2014-09-22 |
| 1851709216 | Derek Calvert | Specialist/Technologist | Lsu Athletic Administration Building, Athletic Training Room, Baton Rouge, LA 70803 | 2014-07-30 |
| 1770924599 | Malena Badon | Clinical Medical Laboratory | 340 East Parker Street, Baton Rouge, LA 70803 | 2013-07-09 |
| 1649394057 | Cheryl Larrieu Bourg | Pharmacist | Lsu Student Health Center Pharmacy, Infirmary Road, Lsu, Baton Rouge, LA 70803 | 2007-03-19 |
| 1548369465 | Louisiana State Univ Students Health Ctr | Pharmacist | Infirmary Road, Room 172 Pharmacy, Baton Rouge, LA 70803 | 2006-09-21 |
| 1912937145 | Louisiana Emergency & Trauma Specialists | Emergency Medicine | 3600 Florida Blvd, Baton Rouge, LA 70803 | 2006-07-04 |
| 1013552512 | Kelly Stephens | Specialist/Technologist | 1 North Stadium Dr, Baton Rouge, LA 70803-0001 | 2019-11-08 |
| 1962062729 | Maria Berthiaume | Physical Medicine & Rehabilitation | Lsu Broussard Center for Athletic Training, Baton Rouge, LA 70803-0001 | 2019-06-14 |
| Find all providers in zip 70803 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953160 | Ryne Michael Smith | Student in an Organized Health Care Education/Training Program | 4124 Lake Limestone Ct, Baton Rouge, LA 70816-6409 | 2020-08-21 |
| 1649881251 | Adam Yarochowicz | Student in an Organized Health Care Education/Training Program | 1385 Crescent Dr, Baton Rouge, LA 70806-8612 | 2020-08-17 |
| 1487265021 | Annadora Janet Bruce-keller | Student in an Organized Health Care Education/Training Program | 6324 Morgan Bend Dr, Baton Rouge, LA 70820-2002 | 2020-08-16 |
| 1093324220 | Raghu Rudraraju | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard Baton Rouge General Mid City Medi, Suite 130, Baton Rouge, LA 70806 | 2020-07-23 |
| 1497374847 | Yara Mouawad | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Suite 130, Baton Rouge, LA 70806 | 2020-04-15 |
| 1235758939 | Nicole Ashley Lecoq | Student in an Organized Health Care Education/Training Program | 12636 E Sheraton Ave, Baton Rouge, LA 70815-6838 | 2020-04-13 |
| 1396364527 | Sai Samyuktha Bandaru | Student in an Organized Health Care Education/Training Program | Brg Mid City Medicine Clinic, 3401 North Boulevard, Sui, Baton Rouge, LA 70806 | 2020-04-08 |
| 1790313161 | Leah Michelle Dlugolecki | Student in an Organized Health Care Education/Training Program | Lsu Psychiatry Residency Program, 5246 Brittany Drive, Baton Rouge, LA 70808 | 2020-03-31 |
| 1477180487 | Samantha Steve Grigus | Student in an Organized Health Care Education/Training Program | 6224 Belle Grove Dr, Baton Rouge, LA 70820-5020 | 2020-03-27 |
| 1851928147 | Joel Byrne | Student in an Organized Health Care Education/Training Program | 5131 Odonovan Dr Fl 5, Baton Rouge, LA 70808-4791 | 2020-03-25 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70803 |
Please comment or provide details below to improve the information on JACQUELINE CASEY CROUCH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.