MEDICARE: JUNIAS MESIDOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN154854	LA

General Provider Information

NPI Number	:	1639037864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNIAS MESIDOR

Provider Business Mailing Address
First Line	:	9081 MONHEGAN AVE
Second Line	:
City	:	BAKER
State	:	LA
Zip	:	70714-7008
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9081 MONHEGAN AVE
Second Line	:
City	:	BAKER
State	:	LA
Zip	:	70714-7008
Country	:	US
Telephone Number	:	561-494-5532
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “ JUNIAS MESIDOR ” Practice Location

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