Healthcare Provider Details

I. General information

NPI: 1194654251
Provider Name (Legal Business Name): TRACHESSA MARKS APRN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S COLLEGE RD STE 220
LAFAYETTE LA
70503-3221
US

IV. Provider business mailing address

9557 GLENNSADE AVE
BATON ROUGE LA
70814-4073
US

V. Phone/Fax

Practice location:
  • Phone: 337-443-2626
  • Fax:
Mailing address:
  • Phone: 225-747-4135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number245980
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: