Provider Demographics
NPI:1902588973
Name:MUSSO, MARC (APRN)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:MUSSO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 SENAC DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-2741
Mailing Address - Country:US
Mailing Address - Phone:504-275-8480
Mailing Address - Fax:
Practice Address - Street 1:3715 PRYTANIA ST STE 400
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3768
Practice Address - Country:US
Practice Address - Phone:504-897-8276
Practice Address - Fax:504-897-8336
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA231991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily