Provider Demographics
NPI:1437275997
Name:DUHON, SUSAN L (RN,CNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:DUHON
Suffix:
Gender:F
Credentials:RN,CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 S POST OAK RD
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-3628
Mailing Address - Country:US
Mailing Address - Phone:337-625-0035
Mailing Address - Fax:337-625-0036
Practice Address - Street 1:914 S POST OAK RD
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-5246
Practice Address - Country:US
Practice Address - Phone:337-625-0035
Practice Address - Fax:337-625-0035
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA32965-1991363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1955981Medicaid
LA721473629001OtherCHAMPUS PROVIDER #
LA1955981Medicaid