Provider Demographics
NPI:1275375784
Name:FUSELIER FAMILY CLINIC
Entity type:Organization
Organization Name:FUSELIER FAMILY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCH NP
Authorized Official - Prefix:
Authorized Official - First Name:KHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FUSELIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-802-0747
Mailing Address - Street 1:302 W 4TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:DEQUINCY
Mailing Address - State:LA
Mailing Address - Zip Code:70633-3404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:302 W 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:DEQUINCY
Practice Address - State:LA
Practice Address - Zip Code:70633-3404
Practice Address - Country:US
Practice Address - Phone:337-222-5524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty