Individual
MRS. JULIE SUSANN DYREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-C APRN
Contact information
Practice address
1 LAKESHORE DR STE 1830, LAKE CHARLES, LA 70629-0114
(337) 437-8383
Mailing address
651 CONNIE DR, LAKE CHARLES, LA 70611-6060
(337) 274-9175
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
214911
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214911
LOUISIANA STATE BOARD OF NURSING
LA
Enumeration date
08/01/2020
Last updated
08/01/2020
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