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General NPI Number Information
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NPI Number | 1558504571
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Entity Type | Individual
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Provider Name | MISS LUCILLE TUESNO
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Gender | Female
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 105 HIGHWAY 2
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City | STERLINGTON
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State | LA
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Zip | 71280-3009
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Country | US
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Telephone | 318-665-0048
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Fax | 318-665-2723
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Provider Business Mailing Address
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Address Line | 126 CHARLOTTE CIR
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City | MONROE
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State | LA
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Zip | 71202-3908
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Country | US
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Telephone | 318-343-4155
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Fax | 318-343-9688
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | PCA15199
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License Number State | LA
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