Provider Demographics
NPI:1790162626
Name:EYMARD, AMANDA (DNS, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:EYMARD
Suffix:
Gender:F
Credentials:DNS, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5599 LA-311
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360
Mailing Address - Country:US
Mailing Address - Phone:985-857-3615
Mailing Address - Fax:985-857-3765
Practice Address - Street 1:5599 LA-311
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-857-3615
Practice Address - Fax:985-857-3765
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08263363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health