Individual
MRS. SHAWNTEL MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, FNP-C
Contact information
Practice address
300 W SAINT MARY BLVD, LAFAYETTE, LA 70506-4638
(337) 233-6593
(337) 235-1032
Mailing address
300 W SAINT MARY BLVD, LAFAYETTE, LA 70506-4638
(337) 233-6593
(337) 235-1032
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP07239
LA
363LF0000X
Family Nurse Practitioner
Primary
AP07239
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2348175
—
LA
Enumeration date
03/07/2013
Last updated
12/19/2023
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