Provider Demographics
NPI:1902077704
Name:O'PRIEN, TANGELA (PMHNP)
Entity Type:Individual
Prefix:
First Name:TANGELA
Middle Name:
Last Name:O'PRIEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:TANGELA
Other - Middle Name:O'PRIEN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15200 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714
Mailing Address - Country:US
Mailing Address - Phone:225-319-2701
Mailing Address - Fax:
Practice Address - Street 1:15200 SCENIC HIGHWAY
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714
Practice Address - Country:US
Practice Address - Phone:225-319-2701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229672363LP0808X
LA116118163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health