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Magnificent Minds Telemed
Psychiatric/Mental Health Nurse Practitioner in Gonzales, Louisiana
NPI 1275255309

Magnificent Minds Telemed is a Psychiatric/Mental Health Nurse Practitioner based in Gonzales, LA and is specialized in Psychiatric/Mental Health. Magnificent Minds Telemed practices in Gonzales, LA. The NPI Number for Magnificent Minds Telemed is 1275255309 and holds a License No. (Louisiana).

The current practice location address for Magnificent Minds Telemed is 630 W Cornerview St Ste B, Gonzales, LA and can be reached out via phone at 225-647-4105. You can also correspond with Magnificent Minds Telemed through the mailing address at PO BOX 359, GONZALES, LA - 70707-0359 (mailing address contact number: 504-915-0705).

Location: 630 W Cornerview St Ste B, Gonzales, LA, 70707-0359
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1275255309
Provider Name
Magnificent Minds Telemed
Credential
Provider Entity Type
Organization
Address
630 W Cornerview St Ste B, Gonzales, LA, 70707-0359
Phone Number
225-647-4105
Fax Number
Provider Enumeration Date
09/15/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
630 W Cornerview St Ste B
City
Gonzales
State
Louisiana
Zip
70737-2742
Phone Number
225-647-4105
Fax Number
person
Provider Business Mailing Address Details
Address
630 W Cornerview St Ste B
City
Gonzales
State
Louisiana
Zip
70737-2742
Phone Number
225-647-4105
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Child & Adolescent Psychiatry
Taxonomy
2084P0804X
License No.
()
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
()
Definition
Definition to come...
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