Keishea Mitchell, LPN

Individual provider Active NPI Licensed Practical Nurse · Vacherie, LA

NPI 1710505367 · NPPES record last updated Jul 9, 2020

Key facts

NPI
1710505367
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
20130449 (LA)
Practice address
3184 Harrison St
Vacherie, LA 70090-7035
Phone
(225) 624-8269
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
20130449LAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 20130449 LA Yes

Addresses

Primary practice location

3184 Harrison St
Vacherie, LA 70090-7035

Mailing address

3184 Harrison St
Vacherie, LA 70090-7035

Other providers in Vacherie, LA

All providers in Vacherie, LA · Licensed Practical Nurse in Louisiana

Sources for this page

Verify at the official NPI Registry.