Individual
SHAVONNE MONA' WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
119 1/2 ARNOULD BLVD, LAFAYETTE, LA 70506-6213
(133) 753-4442
Mailing address
119 1/2 ARNOULD BLVD, LAFAYETTE, LA 70506-6213
(133) 753-4442
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07318
LA
Other
Enumeration date
09/10/2013
Last updated
01/09/2014
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