Healthcare Provider Details

I. General information

NPI: 1699517961
Provider Name (Legal Business Name): ELYSIAN WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2024
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 BARONNE ST STE 201
NEW ORLEANS LA
70115-5377
US

IV. Provider business mailing address

3915 BARONNE ST STE 201
NEW ORLEANS LA
70115-5377
US

V. Phone/Fax

Practice location:
  • Phone: 504-677-8883
  • Fax: 504-201-0547
Mailing address:
  • Phone: 504-677-8883
  • Fax: 504-201-0547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YESENIA SANCHEZ
Title or Position: PROVIDER AND OWNER
Credential: APRN, PMHNP-BC
Phone: 504-677-8883