Healthcare Provider Details

I. General information

NPI: 1578562500
Provider Name (Legal Business Name): SUSAN ADAMS HOWARD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 WATSON RD
WISNER LA
71378-4660
US

IV. Provider business mailing address

PO BOX 8 307 CHISUM STREET
SICILY ISLAND LA
71368-0008
US

V. Phone/Fax

Practice location:
  • Phone: 318-724-7008
  • Fax: 318-724-7646
Mailing address:
  • Phone: 318-389-5727
  • Fax: 318-389-4028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP03683
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: