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General NPI Number Information
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NPI Number | 1720742935
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Entity Type | Organization
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Legal Business Name | CYNTHIA FUSSELL NP, LLC
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 19153 COUNTRY CLUB LN
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City | HAMMOND
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State | LA
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Zip | 70401-3426
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Country | US
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Telephone | 985-507-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 19153 COUNTRY CLUB LN
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City | HAMMOND
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State | LA
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Zip | 70401-3426
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Country | US
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Telephone | 985-507-2020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA C FUSSELL
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Credential | NP
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Telephone | 985-507-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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