Provider Demographics
NPI:1811951189
Name:RANKIN, SYM CUSIMANO (CRNA)
Entity type:Individual
Prefix:MRS
First Name:SYM
Middle Name:CUSIMANO
Last Name:RANKIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:SYM
Other - Middle Name:ANDREA
Other - Last Name:CUSIMANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 2668
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-2668
Mailing Address - Country:US
Mailing Address - Phone:985-230-6685
Mailing Address - Fax:985-230-2173
Practice Address - Street 1:15790 PAUL VEGA MD DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1434
Practice Address - Country:US
Practice Address - Phone:985-230-6685
Practice Address - Fax:985-230-2173
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP02464367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
430035504OtherRR MEDICARE#
LA1397270Medicaid
LA1397270Medicaid