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General NPI Number Information
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NPI Number | 1811471451
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Entity Type | Individual
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Provider Name | HEATHER S. REZZA FNP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 2750 GAUSE BLVD E
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City | SLIDELL
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State | LA
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Zip | 70461-4149
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Country | US
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Telephone | 985-639-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 4333 CALIFORNIA AVE
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City | KENNER
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State | LA
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Zip | 70065-1319
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Country | US
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Telephone | 504-427-2114
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP10158
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License Number State | LA
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