Individual
MR. SHONATHAN EDWARD MERRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
43057 GREEN TREE AVE, GONZALES, LA 70737-8594
(504) 701-4416
(504) 298-0132
Mailing address
43057 GREEN TREE AVE, GONZALES, LA 70737-8594
(504) 701-4416
(504) 298-0132
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
121585
LA
363LF0000X
Family Nurse Practitioner
Primary
201571
LA
Other
Enumeration date
12/01/2017
Last updated
02/09/2022
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