Healthcare Provider Details

I. General information

NPI: 1144323726
Provider Name (Legal Business Name): HEATHER DIANNE DUTY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER DUTY LEMAIRE CRNA

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 GRAMMONT ST STE 101
MONROE LA
71201-7403
US

IV. Provider business mailing address

115 RAYMOND DR
MONROE LA
71203-2432
US

V. Phone/Fax

Practice location:
  • Phone: 318-998-6129
  • Fax:
Mailing address:
  • Phone: 318-343-8047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number725913
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN070024
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAANA046978
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP02864
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: