Individual
SUSAN DIAZ MERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 990-5504
(405) 456-7626
Mailing address
226 MELISSA LN, BOSSIER CITY, LA 71112-8724
(318) 218-7122
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
204173
LA
Other
Enumeration date
06/04/2019
Last updated
09/15/2023
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