# MAGNOLIA HEALTHCARE PROVIDERS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265326870
- **Authorized official:** SHANI GORIO BOOTH APRN (PSYCHIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (985) 507-8346

## Contact information

- **Practice address:** 201 GREENBRIER BLVD, COVINGTON, LA 70433-7236
- **Practice address phone:** (985) 224-4135
- **Practice address fax:** (985) 781-4319
- **Mailing address:** 1752 OX BOW LN, COVINGTON, LA 70433-7273
- **Mailing address phone:** (985) 507-8436
- **Mailing address fax:** (985) 781-4319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2025
- **Last updated:** 06/06/2025