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Individual

AEISHA FOBB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
2117 S BURNSIDE AVE STE A, GONZALES, LA 70737-4669
(225) 461-4679
(225) 430-3275
Mailing address
233 GROVE PARK, LA PLACE, LA 70068-6375
(225) 461-4679
(225) 430-3275

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
204491
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
204491
LA

Other

Enumeration date
08/19/2021
Last updated
05/07/2026
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