Provider Demographics
NPI:1548327588
Name:DAMON, LOUISE MARIE
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:MARIE
Last Name:DAMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:MARIE
Other - Last Name:CHAPDELAINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN
Mailing Address - Street 1:200 MEMPHIS PL
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-2503
Mailing Address - Country:US
Mailing Address - Phone:407-891-7880
Mailing Address - Fax:
Practice Address - Street 1:200 MEMPHIS PL
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-2503
Practice Address - Country:US
Practice Address - Phone:407-891-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9181325163W00000X, 163WC0200X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Not Answered163WE0003XNursing Service ProvidersRegistered NurseEmergency