Provider Demographics
NPI:1699851485
Name:FUSILIER, SUSAN JOHNSON (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JOHNSON
Last Name:FUSILIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W COTTON ST
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-4405
Mailing Address - Country:US
Mailing Address - Phone:337-363-7980
Mailing Address - Fax:
Practice Address - Street 1:312 COURT ST
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-5248
Practice Address - Country:US
Practice Address - Phone:337-363-5525
Practice Address - Fax:337-363-1567
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN027423163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health