=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528537701
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH DUNCAN SAUSSY CPNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2018
-----------------------------------------------------
Last Update Date | 11/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1315 JEFFERSON HWY
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70121-2406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-842-3900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 72255 HICKORY ST
-----------------------------------------------------
City | ABITA SPRINGS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70420-3935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 150-461-6003
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 200844
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------