Provider Demographics
NPI:1356345938
Name:DUNBAR, SUZANNE S
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:S
Last Name:DUNBAR
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 1:1270 ATTAKAPAS DR
Mailing Address - Street 2:STE 502
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6530
Mailing Address - Country:US
Mailing Address - Phone:337-942-9977
Mailing Address - Fax:337-942-9977
Practice Address - Street 1:1270 ATTAKAPAS DR
Practice Address - Street 2:STE 502
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6530
Practice Address - Country:US
Practice Address - Phone:337-942-9977
Practice Address - Fax:337-942-9977
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN052615-APO3972363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1123919Medicaid
LA4C255Medicare UPIN
LA1123919Medicaid