| Vidrine Psychiatry Llc | |
|
689 E Airport Ave Ste 1 Baton Rouge LA 70806-6557 | |
| (225) 268-1412 | |
| Not Available |
| Full Name | Vidrine Psychiatry Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 689 E Airport Ave Ste 1, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Ashton C Vidrine (OWNER) |
| Authorized Official Contact | 2252681412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vidrine Psychiatry Llc 689 E Airport Ave Ste 1 Baton Rouge LA 70806-6557 Ph: () - | Vidrine Psychiatry Llc 689 E Airport Ave Ste 1 Baton Rouge LA 70806-6557 Ph: (225) 268-1412 |
| NPI Number | 1245036540 |
|---|---|
| Provider Enumeration Date | 02/19/2025 |
| Last Update Date | 02/20/2025 |
| Certification Date | 02/20/2025 |
| Medicare PECOS PAC ID | 7214459635 |
|---|---|
| Medicare Enrollment ID | O20250314001968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245036540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Ashton C Vidrine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487402855 PECOS PAC ID: 8123540549 Enrollment ID: I20250314002783 |
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