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General NPI Number Information
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NPI Number | 1164146965
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Entity Type | Individual
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Provider Name | SASHA SUSANA HERNANDEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/27/2022
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 3439 PRYTANIA ST STE 501
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City | NEW ORLEANS
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State | LA
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Zip | 70115-7905
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Country | US
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Telephone | 504-754-2334
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Fax |
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Provider Business Mailing Address
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Address Line | 714 MILLING AVE
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City | LULING
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State | LA
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Zip | 70070-4453
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Country | US
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Telephone | 504-330-4571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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