| Doctor Name: | JENNIFER CHAMPAGNE |
| NPI Number: | 1235529454 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | R871326 |
| Business Practice Address: | 202b Drinkwater Rd Bay St Louis, MS - 395201638 |
| Business Phone Number: | 2284631649 |
| Business Fax Number: | 2284630138 |
| Mailing Address: | 202b Drinkwater Rd, BAY ST LOUIS |
| State: | MS |
| Postal Code: | 395201638 |
| Phone Number: | 2284631649 |
| Fax Number: | 2284630138 |
| NPI Enumeration Date: | 01/26/2015 |
| NPI Last Update Date: | 01/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | R871326 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |