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General NPI Number Information
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NPI Number | 1609149293
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Entity Type | Individual
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Provider Name | JOSEPH A CUSELLA NP
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Gender | Male
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 1214 COOLIDGE BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70503-2621
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Country | US
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Telephone | 337-289-7529
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Fax | 337-289-7190
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Provider Business Mailing Address
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Address Line | 216 BARKSDALE DR
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City | BROUSSARD
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State | LA
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Zip | 70518-9100
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Country | US
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Telephone | 856-207-6594
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | TAP002743
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00480700
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License Number State | NJ
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