Healthcare Provider Details

I. General information

NPI: 1306369780
Provider Name (Legal Business Name): TRANSITIONS IN HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4216 MONTRACHET DR
KENNER LA
70065-1756
US

IV. Provider business mailing address

PO BOX 85
KAPLAN LA
70548-0085
US

V. Phone/Fax

Practice location:
  • Phone: 504-259-4218
  • Fax: 337-643-8407
Mailing address:
  • Phone: 337-643-8424
  • Fax: 337-643-8407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP06810
License Number StateLA

VIII. Authorized Official

Name: BETTY BENNETT
Title or Position: NURSE PRACTITIONER/OWNDER
Credential: APRN
Phone: 504-259-4218