Provider Demographics
NPI:1396363420
Name:GICHIA-WALDROP, JUDITH WANGARI (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:WANGARI
Last Name:GICHIA-WALDROP
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:SICILY ISLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71368-0008
Mailing Address - Country:US
Mailing Address - Phone:318-389-5727
Mailing Address - Fax:318-389-9943
Practice Address - Street 1:126 WATSON RD
Practice Address - Street 2:
Practice Address - City:WISNER
Practice Address - State:LA
Practice Address - Zip Code:71378-4660
Practice Address - Country:US
Practice Address - Phone:318-724-7008
Practice Address - Fax:318-724-7646
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN215790163W00000X
LA221690363LP0808X
TN27897363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse