Glynn Nusbaum, PA
Physician Assistant in Slidell, LA. Individual provider (NPI-1).
NPI number1194453373
StatusActive
Last updated in NPPESJan 20, 2026
Details
- NPI
- 1194453373
- Entity type
- Individual (NPI-1)
- Name
- Glynn Nusbaum
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 15, 2022
- Certification date
- Jan 20, 2026
- Last updated
- Jan 20, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 333829 | LA | Yes |
Practice location
1001 Gause BlvdSlidell, LA 70458-2939
Phone 985-280-2200
Mailing address
1514 Jefferson HwyNew Orleans, LA 70121-2429
Phone 504-842-4000
Other practice locations
971 Robert Blvd
Slidell, LA 70458-2009
Slidell, LA 70458-2009
Phone 985-690-8300
1514 Jefferson Hwy
New Orleans, LA 70121-2429
New Orleans, LA 70121-2429
Phone 504-842-3653 · Fax 504-842-2905
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All 22 Physician Assistant providers in Slidell · All 2,622 providers in Slidell
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