Provider Demographics
NPI:1104220938
Name:C & D TOTAL HEALTH CARE, LLC
Entity Type:Organization
Organization Name:C & D TOTAL HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN-STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:504-319-1519
Mailing Address - Street 1:1417 DRAKE LN
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7784
Mailing Address - Country:US
Mailing Address - Phone:504-319-1519
Mailing Address - Fax:
Practice Address - Street 1:1417 DRAKE LN
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7784
Practice Address - Country:US
Practice Address - Phone:504-319-1519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04524363LF0000X
LAAP04705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty