Organization
MENT PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERICA LAYNE MITCHELL PMHNP (PROVIDER/OWNER)
(225) 888-3628
Entity
Organization
Contact information
Practice address
13392 MAGNOLIA SQUARE DRIVE, BATON ROUGE, LA 70818
(225) 503-0088
Mailing address
PO BOX 64655, BATON ROUGE, LA 70896-4655
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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