Provider Demographics
NPI:1295360444
Name:FUSELIER, AUTUMN ELIZABETH (MSN, APRN, CNM)
Entity type:Individual
Prefix:MRS
First Name:AUTUMN
Middle Name:ELIZABETH
Last Name:FUSELIER
Suffix:
Gender:F
Credentials:MSN, APRN, CNM
Other - Prefix:MISS
Other - First Name:AUTUMN
Other - Middle Name:ELIZABETH
Other - Last Name:QUILLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2201 CLEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4110
Mailing Address - Country:US
Mailing Address - Phone:254-519-8803
Mailing Address - Fax:
Practice Address - Street 1:2207 CLEAR CREEK RD STE 202
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4133
Practice Address - Country:US
Practice Address - Phone:254-519-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CNM06270OtherAMCB