| Fussell Health, Llc | |
|
784 Asbury Dr Mandeville LA 70471-1844 | |
| (985) 287-1579 | |
| Not Available |
| Full Name | Fussell Health, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 784 Asbury Dr, Mandeville, Louisiana |
| Authorized Official Name and Position | Catherine Fussell (OWNER) |
| Authorized Official Contact | 9852871579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fussell Health, Llc 784 Asbury Dr Mandeville LA 70471-1844 Ph: (985) 287-1579 | Fussell Health, Llc 784 Asbury Dr Mandeville LA 70471-1844 Ph: (985) 287-1579 |
| NPI Number | 1528764313 |
|---|---|
| Provider Enumeration Date | 02/02/2023 |
| Last Update Date | 05/16/2024 |
| Medicare PECOS PAC ID | 0446624605 |
|---|---|
| Medicare Enrollment ID | O20230330000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528764313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Catherine B Fussell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750822037 PECOS PAC ID: 2062782485 Enrollment ID: I20190218000297 |
| Provider Name | Mauri C Freitas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760011811 PECOS PAC ID: 2062837438 Enrollment ID: I20200731001940 |
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