Individual provider Active NPI

Kwandaleisha Mikilyn Roberts, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1659293108
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
207087 Issued in LA
Practice address
5750 Johnston St Ste 205
Lafayette, LA 70503-5345
Phone
(337) 991-9276
NPI assigned
Jul 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 207087 LA Primary

Addresses

Primary practice location

5750 Johnston St Ste 205
Lafayette, LA 70503-5345

Mailing address

PO Box 474
Port Barre, LA 70577-0474
Phone (337) 418-9915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1785110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1659293108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "city": "PORT BARRE",
            "state": "LA",
            "postal_code": "705770474",
            "telephone_number": "337-418-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 JOHNSTON ST STE 205",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035345",
            "telephone_number": "337-991-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KWANDALEISHA",
        "middle_name": "MIKILYN",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "207087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.