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NPI Code Detail

MEDICARE: MS. MARY WOOD SURMAN FNP- C

MEDICARE: MS. MARY WOOD SURMAN FNP- C
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
1363LF0000XFamily Nurse PractitionerAP05606LA

General Provider Information

NPI Number : 1801044284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY WOOD SURMAN FNP- C
Provider Business Mailing Address
First Line : 9118 BLUEBONNET CENTRE BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-2993
Country : US
Telephone Number : 225-368-2300
Fax Number : 225-368-2280
Provider Business Practice Location Address
First Line : 9118 BLUEBONNET CENTRE BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-2993
Country : US
Telephone Number : 225-368-2300
Fax Number : 225-368-2280
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2008
Last Update Date : 06/11/2013

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