Healthcare Provider Details

I. General information

NPI: 1811144744
Provider Name (Legal Business Name): CARON SLUSSER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 HIGHLAND PARK PLZ SUITE 208
COVINGTON LA
70433-7129
US

IV. Provider business mailing address

208 HIGHLAND PARK PLZ SUITE 208
COVINGTON LA
70433-7129
US

V. Phone/Fax

Practice location:
  • Phone: 985-875-7660
  • Fax: 985-875-7441
Mailing address:
  • Phone: 985-875-7660
  • Fax: 985-875-7441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN068554 AP05073
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: