Organization
SOUTHERN PSYCHIATRY LLC
Active
Parent organization
MELISSA ELLIS
Other names
Melissa Ellis
Organization subpart
Yes
Provider details
NPI number
Legal business name
MELISSA ELLIS
Authorized official
MELISSA ELLIS APRN (OWNER)
(225) 803-1142
Entity
Organization
Contact information
Practice address
41452 BESS RD, PRAIRIEVILLE, LA 70769-5700
(225) 803-1142
(225) 803-1142
Mailing address
41452 BESS RD, PRAIRIEVILLE, LA 70769-5700
(225) 803-1142
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/30/2019
Last updated
07/13/2021
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