| Mrs Lacy Champagne Mills, FNP | |
|
230 Masonic Drive, Independence, LA 70443 | |
| (985) 878-4174 | |
| (985) 878-9410 |
| Full Name | Mrs Lacy Champagne Mills |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 230 Masonic Drive, Independence, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477873362 | NPI | - | NPPES |
| 2167537 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN106360-AP06092 (Louisiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | AP06092 (Louisiana) | Primary |
| Entity Name | Northlake Medicine And Wellness Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073693958 PECOS PAC ID: 5597764183 Enrollment ID: O20061208000218 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Lacy Champagne Mills, FNP 54190 Sweetwater Rd, Independence, LA 70443-2002 Ph: (985) 878-0938 | Mrs Lacy Champagne Mills, FNP 230 Masonic Drive, Independence, LA 70443 Ph: (985) 878-4174 |
Samantha Magee, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 387 W Railroad Ave, Independence, LA 70443 Phone: 985-606-4080 | |
Andrew Sharp, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 304 West 4th Street, Independence, LA 70443 Phone: 985-878-8030 Fax: 985-878-4416 | |
Denise Maria Linton, A.P.N Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Lallie Kemp Hospital, 52579 Highway 51 South, Independence, LA 70443 Phone: 985-878-9421 Fax: 985-878-1431 | |
Sherry Paretti, A.P.N Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Lallie Kemp Hospital, 52579 Highway 51 South, Independence, LA 70443 Phone: 985-878-9421 Fax: 985-878-1431 | |
Melissa Sterling Smith, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 52579 Highway 51 S, Independence, LA 70443 Phone: 985-974-6158 | |
Shawn Dearie, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 230 Masonic Drive, Independence, LA 70443 Phone: 985-878-4174 Fax: 985-878-9410 | |
Wendy Young, A.P.N. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 52579 Highway 51 South, Lallie Kemp Hospital, Independence, LA 70443 Phone: 985-878-9421 Fax: 985-878-1431 |