Healthcare Provider Details

I. General information

NPI: 1336603257
Provider Name (Legal Business Name): BEVERLY J OWUSU-DUKU DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2019
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5630 CROWDER BLVD STE 100
NEW ORLEANS LA
70127-2430
US

IV. Provider business mailing address

5630 CROWDER BLVD STE 100
NEW ORLEANS LA
70127-2430
US

V. Phone/Fax

Practice location:
  • Phone: 504-362-3000
  • Fax: 504-362-3059
Mailing address:
  • Phone: 504-362-3000
  • Fax: 504-362-3059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number13875
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1927
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: