Provider Demographics
NPI:1851969877
Name:RAMIREZ, MIKALA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MIKALA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MIKALA
Other - Middle Name:RAENEZ
Other - Last Name:EARLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:117 ELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-3632
Mailing Address - Country:US
Mailing Address - Phone:318-728-0281
Mailing Address - Fax:
Practice Address - Street 1:117 ELLINGTON DR
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-3632
Practice Address - Country:US
Practice Address - Phone:318-728-0281
Practice Address - Fax:318-728-0282
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN152971163WG0000X
LA221859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty