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General NPI Number Information
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NPI Number | 1477926715
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Entity Type | Organization
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Legal Business Name | LISA A. CHAVIS LLC
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 3116 STANFORD LEVY RD
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City | DARROW
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State | LA
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Zip | 70725-2137
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Country | US
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Telephone | 337-303-5910
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Fax |
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Provider Business Mailing Address
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Address Line | 3116 STANFORD LEVY RD
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City | DARROW
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State | LA
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Zip | 70725-2137
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Country | US
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Telephone | 337-501-7737
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MISS LISA A CHAVIS
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Credential | APRN, PMHNP-BC
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Telephone | 337-303-5910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP07584
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License Number State | LA
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