Tate Fazio, CRNA

NPI 1295505519 · on the registry since 2024 · sole proprietor

Practice

Address: 600 S Pine St
Deridder, LA 70634
Phone: (337) 401-5253
Organisation at this address: Beauregard - Vernon Mri Llc
Concord Medical Group, Pllc
Beauregard Emergency Group Llc
Beauregard Memorial Home Health
Beauregard Physician Group, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 11

Registry record

Primary taxonomy: 367500000X
367500000X
Licence states on file: LA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-01-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana