Provider Demographics
NPI:1588965461
Name:PAMELA DUPONT PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:PAMELA DUPONT PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:T
Authorized Official - Last Name:DUPONT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:504-363-2121
Mailing Address - Street 1:4480 GENERAL DEGAULLE DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-6941
Mailing Address - Country:US
Mailing Address - Phone:504-363-2121
Mailing Address - Fax:504-364-8044
Practice Address - Street 1:4480 GENERAL DEGAULLE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-6941
Practice Address - Country:US
Practice Address - Phone:504-363-2121
Practice Address - Fax:504-364-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty