MEDICARE: LEE FUSILIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	243472	LA

General Provider Information

NPI Number	:	1780537878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE FUSILIER

Provider Business Mailing Address
First Line	:	1507 WATKINS ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5851
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1507 WATKINS ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-5851
Country	:	US
Telephone Number	:	337-842-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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Directions to “ LEE FUSILIER ” Practice Location

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