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Organization
NOLA INNOVATIVE PSYCHIATRIC SERVICES, LLC
Active
Organization
NOLA INNOVATIVE PSYCHIATRIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERREN WILSON NP (OWNER)
(504) 330-6038
Entity
Organization
Contact information
Practice address
3520 GENERAL DEGAULLE DR, STE 4098, NEW ORLEANS, LA 70114-6757
(504) 330-6308
Mailing address
3320 N ARNOULT RD, APT 226, METAIRIE, LA 70002-3396
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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