Provider Demographics
NPI:1285139758
Name:VALLADARES, SUZETTE M (RN)
Entity type:Individual
Prefix:MS
First Name:SUZETTE
Middle Name:M
Last Name:VALLADARES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6206
Mailing Address - Country:US
Mailing Address - Phone:504-827-2701
Mailing Address - Fax:504-827-2715
Practice Address - Street 1:3330 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6206
Practice Address - Country:US
Practice Address - Phone:504-827-2701
Practice Address - Fax:504-827-2715
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA059067163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse