Healthcare Provider Details

I. General information

NPI: 1730739707
Provider Name (Legal Business Name): SUZANNE MICHELLE FOURRIER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 MAGAZINE ST
NEW ORLEANS LA
70130-5016
US

IV. Provider business mailing address

2347 CHIPPEWA ST
NEW ORLEANS LA
70130-5470
US

V. Phone/Fax

Practice location:
  • Phone: 504-529-5558
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number21909854
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: