Mixon, Kevin O

Mixon, Kevin O is an individual health care provider with primary practice located at 15770 Paul Vega Md Dr Ste 202 , Hammond LA 70403-1475. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Mixon, Kevin O can be contacted via phone (985) 230-7495.

Contact Information

Primary practice address
15770 Paul Vega Md Dr Ste 202 Hammond LA 70403-1475
Phone: (985) 230-7495
Fax: (985) 230-7496
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP03979 Louisiana

Profile Details

NPI number 1588803928
LBN Legal business name Mixon, Kevin O
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2009
Last updated Dec 29th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588803928 NPPES
Louisiana Other P01359174 MEDICARE RR
Louisiana MEDICAID 2142348 MEDICARE RR

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