Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LISA BOUDREAUX MIMNAGH
Active Sole ProprietorPsychiatric/Mental Health Nurse Practitioner · GRAY, LA
Registration Details
- NPI Number
- 1063950285
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 8, 2017 (9.2330364683237 yrs)
- Last Updated
- Feb 8, 2017
- License
-
AP09186 (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
151 GAINESVILLE DRGRAY, LA, 703594525Browse LA providers · Browse ZIP 70359
- Phone
- 9857902568
- Primary Specialty
-
Psychiatric/Mental Health Nurse Practitioner
363LP0808X
Other Psychiatric/Mental Health Nurse Practitioner Providers in GRAY, LA
| Name | Credential | NPI |
|---|---|---|
| MRS. PAMELA DUPONT | NP | 1285662254 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.