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Organization
MAGNOLIA HEALTHCARE PROVIDERS
Active
Organization
MAGNOLIA HEALTHCARE PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANI GORIO BOOTH APRN (PSYCHIATRIC NURSE PRACTITIONER)
(985) 507-8346
Entity
Organization
Contact information
Practice address
201 GREENBRIER BLVD, COVINGTON, LA 70433-7236
(985) 224-4135
(985) 781-4319
Mailing address
1752 OX BOW LN, COVINGTON, LA 70433-7273
(985) 507-8436
(985) 781-4319
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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