Provider Demographics
NPI:1700292281
Name:RITCH, ELLEN DECLOUET (PMHNP-BC, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:DECLOUET
Last Name:RITCH
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 LA RUE FRANCE STE 202
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3133
Mailing Address - Country:US
Mailing Address - Phone:337-534-0971
Mailing Address - Fax:337-534-0974
Practice Address - Street 1:302 LA RUE FRANCE STE 202
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3133
Practice Address - Country:US
Practice Address - Phone:337-534-0971
Practice Address - Fax:337-534-0974
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07881363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2400908Medicaid