Provider Demographics
NPI:1558504571
Name:TUESNO, LUCILLE
Entity Type:Individual
Prefix:MISS
First Name:LUCILLE
Middle Name:
Last Name:TUESNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 CHARLOTTE CIR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-3908
Mailing Address - Country:US
Mailing Address - Phone:318-343-4155
Mailing Address - Fax:318-343-9688
Practice Address - Street 1:105 HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:STERLINGTON
Practice Address - State:LA
Practice Address - Zip Code:71280-3009
Practice Address - Country:US
Practice Address - Phone:318-665-0048
Practice Address - Fax:318-665-2723
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA151993747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant