Individual
SHANNON L MOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, APRN FNP-C
Contact information
Practice address
1514 DOCTORS DR, BOSSIER CITY, LA 71111-3379
(318) 549-2500
(318) 549-2555
Mailing address
PO BOX 310, CALHOUN, LA 71225-0310
(318) 237-1344
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
RN119419
LA
363LF0000X
Family Nurse Practitioner
Primary
214569
LA
Other
Enumeration date
07/20/2020
Last updated
02/22/2025
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