Individual
LISA RUSSO AUTHEMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN-APRN
Contact information
Practice address
911 VERRET ST, HOUMA, LA 70360-4637
(985) 876-7388
(985) 872-2878
Mailing address
911 VERRET ST, HOUMA, LA 70360-4637
(985) 876-7388
(985) 872-2878
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN078449
LA
363LF0000X
Family Nurse Practitioner
Primary
AP05301
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030431
—
LA
Enumeration date
09/14/2007
Last updated
06/21/2013
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