Provider Demographics
NPI:1538784244
Name:CROCHET, SUSAN FOLSE (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:FOLSE
Last Name:CROCHET
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 1:204 N TERREBONNE DR
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:LA
Mailing Address - Zip Code:70359-6402
Mailing Address - Country:US
Mailing Address - Phone:985-790-9380
Mailing Address - Fax:
Practice Address - Street 1:204 N TERREBONNE DR
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:LA
Practice Address - Zip Code:70359-6402
Practice Address - Country:US
Practice Address - Phone:985-790-9380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LARN084812163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator