Provider Demographics
NPI:1750767927
Name:HYMEL, MINDY GAUBERT (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:GAUBERT
Last Name:HYMEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:MINDY
Other - Middle Name:MICHELLE
Other - Last Name:GAUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:122 REFUGE DR
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-3239
Mailing Address - Country:US
Mailing Address - Phone:504-201-1254
Mailing Address - Fax:
Practice Address - Street 1:1057 PAUL MAILLARD RD
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-4349
Practice Address - Country:US
Practice Address - Phone:985-785-6242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200878363AM0700X
MSPA00558363A00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2402463Medicaid
MS09051054Medicaid
MS09051054Medicaid