| Doctor Name: | MRS. CYNTHIA CRAWFORD FUSSELL |
| NPI Number: | 1194916163 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | APO3602 |
| Business Practice Address: | 921 Avenue G Kentwood, LA - 704442636 |
| Business Phone Number: | 9852290717 |
| Business Fax Number: | |
| Mailing Address: | 19153 Country Club Ln, HAMMOND |
| State: | LA |
| Postal Code: | 704013426 |
| Phone Number: | 9855072020 |
| Fax Number: | |
| NPI Enumeration Date: | 08/06/2007 |
| NPI Last Update Date: | 11/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APO3602 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |