Healthcare Provider Details

I. General information

NPI: 1174288864
Provider Name (Legal Business Name): IT'S A BEAUTIFUL MIND CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 KNIGHT ST STE 412
SHREVEPORT LA
71105-2413
US

IV. Provider business mailing address

PO BOX 4132
SHREVEPORT LA
71134-0132
US

V. Phone/Fax

Practice location:
  • Phone: 318-218-5763
  • Fax: 318-374-2506
Mailing address:
  • Phone: 318-243-2411
  • Fax: 318-374-2506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. JASCHANDRIA BELL
Title or Position: CEO
Credential: FNP, PMHNP
Phone: 318-243-2411