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Individual

JEREMY BERNARD SANDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN, PMHNP-BC

Contact information

Practice address
314 W HALE ST, LAKE CHARLES, LA 70601
(337) 660-8918
(337) 433-3013
Mailing address
5000 LAKE ST # 6781, LAKE CHARLES, LA 70605-6500
(337) 660-8918
(337) 433-3013

Taxonomy

Speciality
Code
Description
License number
State
2084P0005X
Neurodevelopmental Disabilities Physician
AP09799
LA
2084P0800X
Psychiatry Physician
Primary
AP09799
LA
2084P0800X
Psychiatry Physician
RN128743
LA
2084P0802X
Addiction Psychiatry Physician
AP09799
LA
2084P0804X
Child & Adolescent Psychiatry Physician
AP09799
LA
2084P0805X
Geriatric Psychiatry Physician
AP09799
LA

Other

Enumeration date
01/23/2018
Last updated
10/29/2019
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