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NPI Code Detail

MEDICARE: MR. LOUIS-JACQUES JOSEPH PMHNP-BC

MEDICARE: MR. LOUIS-JACQUES JOSEPH PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11018290FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669128716
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LOUIS-JACQUES JOSEPH PMHNP-BC
Provider Business Mailing Address
First Line : 8570 GRANITE CT STE 101
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-4240
Country : US
Telephone Number : 833-769-3524
Fax Number : 239-256-7516
Provider Business Practice Location Address
First Line : 8570 GRANITE CT STE 101
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-4240
Country : US
Telephone Number : 833-769-3524
Fax Number : 239-256-7516
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2022
Last Update Date : 01/12/2026

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Directions to “ MR. LOUIS-JACQUES JOSEPH PMHNP-BC” Practice Location

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