Provider Demographics
NPI:1609331149
Name:SEICSHNAYDRE, ALICIA (PMHNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:SEICSHNAYDRE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SAINT ANN DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3394
Mailing Address - Country:US
Mailing Address - Phone:985-951-2250
Mailing Address - Fax:985-951-2253
Practice Address - Street 1:215 SAINT ANN DR STE 2
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3394
Practice Address - Country:US
Practice Address - Phone:985-951-2250
Practice Address - Fax:985-951-2253
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP203280363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health