Southern Psychiatry LLC
Nurse Practitioner, Psych/Mental Health in Prairieville, LA. Organization (NPI-2).
NPI number1982258745
StatusActive
Last updated in NPPESJul 13, 2021
Details
- NPI
- 1982258745
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Psychiatry LLC
- Organization subpart
- Yes
- Enumeration date
- Jul 30, 2019
- Certification date
- Jul 13, 2021
- Last updated
- Jul 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Other names
- Melissa Ellis (Other Name)
Practice location
41452 Bess RdPrairieville, LA 70769-5700
Phone 225-803-1142 · Fax 225-803-1142
Mailing address
41452 Bess RdPrairieville, LA 70769-5700
Phone 225-803-1142
Authorized official
Melissa Ellis
Owner
2258031142
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