Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 08839 | LA |
NPI | 1063960433 |
---|---|
Provider Name | Emily Fusilier |
First Address | Baton Rouge, LA 70809-8636 |
Second Address | Baton Rouge, LA 70809-8636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2016 |
Last Update Date | 19/03/2021 |