Individual
MRS. HEATHER DOW SHOULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1434
(985) 345-2700
Mailing address
577 PONDEROSA DR, PONCHATOULA, LA 70454-9428
(504) 232-5404
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
226156
LA
363LF0000X
Family Nurse Practitioner
226156
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15653286
CAQH
LA
Enumeration date
06/23/2022
Last updated
11/15/2023
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