JENNA ELIZABETH DAVILA (NPI# 1568803450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568803450 |
| Entity Type | Individual |
| Full Name | JENNA ELIZABETH DAVILA |
| Credential | IDMT |
| Practice Address |
293 Avondale Ln Bossier City LA 71112-4266 |
| Practice Telephone | 2108370240 |
| Mailing Telephone | 2108370240 |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2013-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588130009 | Jenna Davila | Social Worker | 4031 W Dayton St, Mchenry, IL 60050-8377 | 2018-10-23 |
| Street Address |
293 AVONDALE LN |
| City | BOSSIER CITY |
| State | LA |
| Zip Code | 71112-4266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154810349 | Brittany Ariel Boone | Case Manager/Care Coordinator | 2323 Old Minden Rd Ste 500, Bossier City, LA 71112 | 2018-05-03 |
| 1396254520 | Abartllc | Non-emergency Medical Transport (VAN) | 400 John Wesley Blvd Apt 195, Bossier City, LA 71112 | 2017-09-19 |
| 1124547708 | Kendra Webster | Counselor | 3018 Old Minden Rd. Ste 1200, Bossier City, LA 71112 | 2017-09-14 |
| 1851818009 | Latonya Renee' Williams | Case Manager/Care Coordinator | 5383 Bluebell Dr, Bossier City, LA 71112 | 2017-08-28 |
| 1578084299 | Christian Sledge | Counselor | 1011 Princeton Ave, Bossier City, LA 71112 | 2017-07-03 |
| 1861925240 | Kyanna Williams Cosby | Counselor | 4009 Parkway Dr, Bossier City, LA 71112 | 2017-04-04 |
| 1962858191 | Jemeel Latrice Webb | Case Manager/Care Coordinator | 1787 Southview Drive, Bossier City, LA 71112 | 2016-05-06 |
| 1174986244 | Jaquitua Russell | Case Manager/Care Coordinator | 5005 Longstreet Pl Unit 1, Bossier City, LA 71112 | 2016-04-05 |
| 1528423175 | Deanna Lorraine Edwards | Contractor | 4007 Parkway Dr, Bossier City, LA 71112 | 2015-12-28 |
| 1700258605 | Derrick Thomas | Counselor | 2601 Hoyer St, Bossier City, LA 71112 | 2015-10-30 |
| Find all providers in zip 71112 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053684985 | Rashad C. Holley | Military Health Care Provider | 1225 Villaggio Blvd, Bossier City, LA 71111-7438 | 2012-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902318314 | Alexander Arrieta | Military Health Care Provider | 1917 Liberty Ave S, Barksdale Afb, LA 71110-2162 | 2017-10-26 |
| 1043566698 | Mikka Slater | Military Health Care Provider | 1503 University Ave, Monroe, LA 71203-3550 | 2012-08-01 |
| 1033477757 | Shandy Gore | Military Health Care Provider | 5610 Buncombe Rd Apt 907, Shreveport, LA 71129-3617 | 2012-05-01 |
| 1710243126 | Mark Butanis | Military Health Care Provider | 3913 N I 10 Service Rd W Apt 239, Metairie, LA 70002-6828 | 2012-04-10 |
| 1790014660 | Athena Lee Castilleja Ezernack | Military Health Care Provider | 407 Barksdale Blvd E, Barksdale Afb, LA 71110-2125 | 2009-12-23 |
| 1730313602 | Brian W Signal | Military Health Care Provider | 243 Cutiss Rd, 2 Mdg, Barksdale Afb, LA 71110 | 2009-05-07 |
| 1891179578 | Heather C Acres | Military Health Care Provider | 243 Curtiss Rd, Barksdale Afb, LA 71110-2425 | 2015-07-13 |
| 1598909970 | Jody Lee Ohmer | Military Health Care Provider | 243 Curtiss Rd, Barksdale Afb, LA 71110-2425 | 2009-04-28 |
| 1194969550 | Charles Wayne Sheffield | Military Health Care Provider | 243 Curtiss Rd, Barksdale Afb, LA 71110-2425 | 2009-04-28 |
| 1346484805 | Rachonn Shalette Williamson | Military Health Care Provider | 243 Curtiss Rd, St 100 (2amds/sgpf), Barksdale Afb, LA 71110-2425 | 2009-04-28 |
| Find all providers with the same taxonomy | ||||
| City | BOSSIER CITY |
| Zip Code | 71112 |
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| 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.