Healthcare Provider Details

I. General information

NPI: 1801714332
Provider Name (Legal Business Name): MAKAYLA MESHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S MYRTLE ST
JUNCTION CITY LA
71256-9516
US

IV. Provider business mailing address

101 S MYRTLE ST
JUNCTION CITY LA
71256-9516
US

V. Phone/Fax

Practice location:
  • Phone: 870-789-8665
  • Fax:
Mailing address:
  • Phone: 870-789-8665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number216924
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: