Bleu Med Spa & Laser Clinic, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

BLEU MED SPA & LASER CLINIC, LLC

Practice address

3769 Pontchartrain Dr Ste 5
Slidell, LA 70458-4852

Phone

(985) 201-9976

NPI assigned

Jan 30, 2023

Last updated

Feb 3, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Mitrik

Title

Owner

Phone

(985) 201-9976

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1225744642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 GRAND CHAMPIONS LN",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588852",
            "telephone_number": "985-201-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3769 PONTCHARTRAIN DR STE 5",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704584852",
            "telephone_number": "985-201-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLEU MED SPA & LASER CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "MITRIK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-201-9976"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dalmer A Blanchard, LCSW
• Shelly A Blanchard, LCSW
• Shelley Smith Blanda, APRN, PMHNP-BC, RN
• Peter B Blessey, MD
• Shannon Smith Blestel, LCSW
• Josephine Bloemer
• Gretchen V. Blondeau, PHARM.D., R.PH.
• Rebecca Lynn Blum, DDS
• BNB Transportation LLC
• Rondell N Bob, PT, DPT

• Primary Care Nurse Practitioner in Slidell, LA
• Providers in Slidell, LA by specialty
• Primary Care Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.