Provider Demographics
NPI:1588184220
Name:WILLIAMS, MONIQUE PIERRE (NP)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:PIERRE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5635 MAIN ST STE A-284
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-4083
Mailing Address - Country:US
Mailing Address - Phone:225-933-8692
Mailing Address - Fax:855-595-5949
Practice Address - Street 1:9418 BROOKLINE AVE STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1428
Practice Address - Country:US
Practice Address - Phone:225-933-8692
Practice Address - Fax:855-595-2949
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09367363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2461800Medicaid