Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP04107 | LA |
NPI | 1053738757 |
---|---|
Provider Name | Ms. Susan Tortorich |
First Address | Metairie, LA 70006-4182 |
Second Address | Metairie, LA 70006-4182 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2014 |
Last Update Date | 25/03/2014 |