Organization
NORTHSHORE ANESTHESIA PRACTICE, LLC
Active
Organization
NORTHSHORE ANESTHESIA PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MICHAEL BURDETT CRNA (OWNER)
(985) 687-7656
Entity
Organization
Contact information
Practice address
24575 VERNEIUL LN, PONCHATOULA, LA 70454-6211
(985) 687-7656
Mailing address
24575 VERNEIUL LN, PONCHATOULA, LA 70454-6211
(985) 687-7656
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN098829AP05096
LA
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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