Individual
THERESA JEANNE NUTTLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 RIDGEWOOD DR, METAIRIE, LA 70001-6126
(504) 460-0270
Mailing address
1978 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(504) 460-0270
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD.206812
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1883972
—
LA
Enumeration date
04/23/2009
Last updated
09/13/2016
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