Individual
SUSANNA ELIZABETH BLOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3600 GATES BLVD, PORT ARTHUR, TX 77642-3858
(800) 893-9698
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
713213
TX
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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