Individual
ELIZABETH D'ANTONIO LA SALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
42570 S AIRPORT RD, HAMMOND, LA 70403-0946
(985) 510-6135
(985) 510-6202
Mailing address
PO BOX 20452, YPS-CREDENTIALING, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN098142
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024228
—
LA
01
—
P01023462
RR MEDICARE
LA
Enumeration date
06/15/2007
Last updated
03/12/2015
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