Healthcare Provider Details

I. General information

NPI: 1972774032
Provider Name (Legal Business Name): DAMIAN GODFREY DUHON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MEDICAL CENTER BLVD. SUITE S-450
MARRERO LA
70072
US

IV. Provider business mailing address

P.O. BOX 1520
MARRERO LA
70073
US

V. Phone/Fax

Practice location:
  • Phone: 504-349-6423
  • Fax: 504-349-6062
Mailing address:
  • Phone: 504-349-6423
  • Fax: 504-349-6062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN089903
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: