Individual provider · Type 1 NPI
Jonathan Lamont Mixon
Psychiatric/Mental Health Nurse Practitioner · Lafayette, LA
NPI number
1508260720
Active
Practice location
106 Heymann Blvd
Lafayette, LA 70503-2322
Mailing address
1713 Pembroke St
New Iberia, LA 70563-8616
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | AP08044 (LA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1508260720
Jonathan Lamont Mixon's National Provider Identifier is 1508260720, issued on Oct 17, 2014. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Lafayette, LA. The record was last updated on Jan 12, 2015.