Jessica Ezejimofor, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

239767 Issued in LA

Practice address

37283 Swamp Rd Ste 803
Prairieville, LA 70769-3329

Phone

(225) 254-9589

Fax

(225) 208-7267

NPI assigned

Feb 10, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.ezejimofor.1@32267.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gulf Coast Behavioral Health, LLC

  • Substance Abuse Rehabilitation Facility
  • Prairieville, LA
  • NPI 1043956527

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1891500765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37283 SWAMP RD STE 803",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693329",
            "telephone_number": "225-254-9589",
            "fax_number": "225-208-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37283 SWAMP RD STE 803",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693329",
            "telephone_number": "225-254-9589",
            "fax_number": "225-208-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEJIMOFOR",
        "first_name": "JESSICA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "239767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerald Medical Supply
• Misty Entremont
• Essential Occupational Health and Safety V, LLC
• Brett A Evans
• Kristen Eymard
• Lauren Fairbanks, L.O.T.R., C.H.T.
• Alicia Eichmann Faldetta, OTD, OTR/L
• Fame Maker Productions, LLC
• Sarah Joyce Farr
• Fayes Transportation

• Psychiatric/Mental Health Nurse Practitioner in Prairieville, LA
• Providers in Prairieville, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.