Healthcare Provider Details

I. General information

NPI: 1356345938
Provider Name (Legal Business Name): MRS. SUZANNE S. DUNBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 ATTAKAPAS DR STE 502
OPELOUSAS LA
70570-6530
US

IV. Provider business mailing address

1270 ATTAKAPAS DR STE 502
OPELOUSAS LA
70570-6530
US

V. Phone/Fax

Practice location:
  • Phone: 337-942-9977
  • Fax: 337-942-9977
Mailing address:
  • Phone: 337-942-9977
  • Fax: 337-942-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN052615-APO3972
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: