Individual
CLEO 'TREY' DEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
2408 BROADMOOR BLVD, SUITE B, MONROE, LA 71201-2994
(318) 807-0525
(318) 807-1077
Mailing address
130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
08285
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2398938
—
LA
Enumeration date
07/08/2015
Last updated
09/12/2016
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