Provider Demographics
NPI:1336519776
Name:RAMPERSANT, LA'QUANDRA (NP)
Entity Type:Individual
Prefix:
First Name:LA'QUANDRA
Middle Name:
Last Name:RAMPERSANT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:QUANDRA
Other - Middle Name:
Other - Last Name:RAMPERSANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, FNP-C, PMHNP-BC
Mailing Address - Street 1:718 W SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6627
Mailing Address - Country:US
Mailing Address - Phone:843-367-5782
Mailing Address - Fax:
Practice Address - Street 1:200 OCEANGATE STE 100
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4317
Practice Address - Country:US
Practice Address - Phone:888-898-7969
Practice Address - Fax:888-295-7665
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2023102598364SP0813X
SC19755363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, GeropsychiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP4853Medicaid