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Mary Mancuso Hearod, NP
Family Nurse Practitioner in Lake Charles, Louisiana
NPI 1144760414

Mary Mancuso Hearod is a Family Nurse Practitioner based in Dallas, LA and is specialized in Family. Mary Mancuso Hearod practices in Lake Charles, LA and has the professional credentials of NP. The NPI Number for Mary Mancuso Hearod is 1144760414 and holds a License No. AP09122 (Louisiana).

The current practice location address for Mary Mancuso Hearod is 2770 3Rd Ave Ste 345, Lake Charles, LA and can be reached out via phone at 337-494-4785 and via fax at 337-494-4786.

Location: 2770 3Rd Ave Ste 345, Lake Charles, LA, 75312-2623
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Provider Profile Details
NPI Number
1144760414
Provider Name
Mary Mancuso Hearod
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
2770 3Rd Ave Ste 345, Lake Charles, LA, 75312-2623
Phone Number
337-494-4785
Fax Number
337-494-4786
Provider Enumeration Date
03/06/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AP09122 01 LA STATE MEDICAL LICENSE
2439740 05 LA
institution
Provider Business Practice Location Address Details
Address
2770 3Rd Ave Ste 345
City
State
Zip
70601-8994
Phone Number
337-494-4785
Fax Number
337-494-4786
person
Provider Business Mailing Address Details
Address
2770 3Rd Ave Ste 345
City
State
Zip
70601-8994
Phone Number
337-494-4785
Fax Number
337-494-4786
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
AP09122 (Louisiana)
Definition
Definition to come...
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