Most Relevant Information
Provider Data
| NPI Number: | 1003819533 |
| Provider Name: | SUSAN J. AYCOCK CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | RN064988 |
Most Important Dates
| Enumeration Date: | 05/30/2005 |
| Last Updated: | 04/04/2023 |
Provider Practice Location
1001 GAUSE BLVD
SLIDELL
LA
704582939
Practice Location Phone/Fax
| Phone: | 9856498767 |
| Fax: |
Provider Mailing Location
120 INNWOOD DR
COVINGTON
LA
704339123
Provider Mailing Phone/Fax
| Phone: | 9858923225 |
| Fax: |