Organization · Type 2 NPI
Premier Integrative Wellness LLC
Psychiatric/Mental Health Nurse Practitioner · Shreveport, LA
NPI number
1831076819
Active
Practice location
839 Kings Hwy Ste 125
Shreveport, LA 71104-4258
Fax (318) 228-2054
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | None listed |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
| Primary Care Nurse Practitioner | 363LP2300X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1831076819
Premier Integrative Wellness LLC's National Provider Identifier is 1831076819, issued on Aug 20, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Shreveport, LA. The record was last updated on Aug 21, 2025.