Provider Demographics
NPI:1184276735
Name:HENRIQUEZ, LILIA (PMHNP)
Entity type:Individual
Prefix:
First Name:LILIA
Middle Name:
Last Name:HENRIQUEZ
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:LILIA
Other - Middle Name:
Other - Last Name:ARCEMENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD STE S750
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3197
Mailing Address - Country:US
Mailing Address - Phone:504-669-8246
Mailing Address - Fax:
Practice Address - Street 1:4421 CONLIN ST STE 101
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2145
Practice Address - Country:US
Practice Address - Phone:504-455-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-14
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN136138163W00000X
LA207909363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily