# SURGICAL ASSISTANTS OF ACADIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770007684
- **Authorized official:** MRS. FALLON ALIESHA FUNDERBURK BSN, RN, CNOR, RNFA (REGISTERED NURSE FIRST ASSISTANT)
- **Authorized official phone:** (318) 218-0515

## Contact information

- **Practice address:** 1101 KALISTE SALOOM RD, LAFAYETTE, LA 70508-5705
- **Practice address phone:** (337) 769-4100
- **Mailing address:** 219 RUE DE FREJUS, BROUSSARD, LA 70518-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WR0006X | Registered Nurse First Assistant | RN105855 | LA | Yes |

## Other

- **Enumeration date:** 08/01/2017
- **Last updated:** 08/01/2017