Provider Demographics
NPI:1841505872
Name:MITCHELL, NAKEISHA LEBEAUF (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:NAKEISHA
Middle Name:LEBEAUF
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 N AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-2101
Mailing Address - Country:US
Mailing Address - Phone:225-644-3184
Mailing Address - Fax:
Practice Address - Street 1:1607 N AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2101
Practice Address - Country:US
Practice Address - Phone:225-644-3184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-14
Last Update Date:2010-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist