Individual
MIKKESHIA GREMILLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP-BC
Contact information
Practice address
8595 PICARDY AVE STE 100, BATON ROUGE, LA 70809-3674
(225) 716-2221
Mailing address
4059 LASSEN DR, BATON ROUGE, LA 70814-5125
(225) 716-2221
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1141246
TX
363LF0000X
Family Nurse Practitioner
Primary
223858
LA
Other
Enumeration date
01/18/2022
Last updated
12/02/2024
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