Provider Demographics
NPI:1720038003
Name:ZUBER, RITA DE LANCEY (NP)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:DE LANCEY
Last Name:ZUBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 CYPRESS ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5286
Mailing Address - Country:US
Mailing Address - Phone:318-644-2573
Mailing Address - Fax:318-644-7177
Practice Address - Street 1:3101 CYPRESS ST
Practice Address - Street 2:SUITE 9
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5286
Practice Address - Country:US
Practice Address - Phone:318-644-2573
Practice Address - Fax:318-644-7177
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3282363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA55656Medicaid
LA5X556Medicare ID - Type Unspecified
LAS57518Medicare UPIN