Healthcare Provider Details

I. General information

NPI: 1740018563
Provider Name (Legal Business Name): CHRISTIAN MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date: 02/05/2025
Reactivation Date: 03/20/2025

III. Provider practice location address

433 BAGDAD RD
WESTLAKE LA
70669-3503
US

IV. Provider business mailing address

433 BAGDAD RD
WESTLAKE LA
70669-3503
US

V. Phone/Fax

Practice location:
  • Phone: 337-502-8108
  • Fax:
Mailing address:
  • Phone: 92-346-2895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: