MEDICARE: DR. JANELLE LOUIS ND, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN322974	GA
2	175F00000X	Naturopath	099.0134086	VT
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP.70013349-NP	WA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RNP325553	AZ

General Provider Information

NPI Number	:	1659823797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANELLE LOUIS ND, PMHNP-BC

Provider Business Mailing Address
First Line	:	4539 N 22ND ST # 4828
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4539 N 22ND ST # 4828
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	520-200-8993
Fax Number	:	480-210-0004

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2016
Last Update Date	:	06/30/2025

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