Provider Demographics
NPI:1265844237
Name:SOUTHEASTERN LOUISIANA UNIVERSITY
Entity Type:Organization
Organization Name:SOUTHEASTERN LOUISIANA UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KALA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-988-9812
Mailing Address - Street 1:SLU 10720
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70402-0001
Mailing Address - Country:US
Mailing Address - Phone:985-549-5322
Mailing Address - Fax:985-549-3810
Practice Address - Street 1:SLU 10720
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70402-0001
Practice Address - Country:US
Practice Address - Phone:985-549-5322
Practice Address - Fax:985-549-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty