Provider Demographics
NPI:1417565615
Name:CHELETTE, BOBBY DARRELL (PMHNP-BC AND FNP-BC)
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:DARRELL
Last Name:CHELETTE
Suffix:
Gender:M
Credentials:PMHNP-BC AND FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71221-0792
Mailing Address - Country:US
Mailing Address - Phone:318-283-8887
Mailing Address - Fax:318-281-2559
Practice Address - Street 1:420 WHEELIS ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71292-3940
Practice Address - Country:US
Practice Address - Phone:318-556-8455
Practice Address - Fax:318-556-8456
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA214496363LP2300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care