Provider Demographics
NPI:1114681350
Name:CYPRESS HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:CYPRESS HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAIMIE
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:MELANCON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:337-230-4645
Mailing Address - Street 1:327 IBERIA ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-6370
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:327 IBERIA ST STE 3A
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-6370
Practice Address - Country:US
Practice Address - Phone:337-230-4645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2422979Medicaid
LA2410849Medicaid