Individual
SHAWNA MARIE LONGORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1505 E BERT KOUN LOOP # 101, SHREVEPORT, LA 71105-5723
(318) 681-7480
Mailing address
179 FARRIS LN, FRIERSON, LA 71027-2060
(318) 347-6885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200157
LA
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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