Provider Demographics
NPI:1376257006
Name:NAVARRE, ASHLEY D (PMHNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:NAVARRE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:NAVARRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ASHLEY NAVARRE PMHNP
Mailing Address - Street 1:425 W AIRLINE HWY STE K #1219
Mailing Address - Street 2:
Mailing Address - City:LAPLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068
Mailing Address - Country:US
Mailing Address - Phone:504-534-6151
Mailing Address - Fax:
Practice Address - Street 1:425 W AIRLINE HWY STE L
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3818
Practice Address - Country:US
Practice Address - Phone:504-534-6151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202213163W00000X, 363LP0808X
TX1131121363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2629981Medicaid
LA1376257006Medicaid