Individual
SHANNON HUEBEL KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2555 JIMMY JOHNSON BLVD, PORT ARTHUR, TX 77640-2007
(409) 853-5400
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP136641
TX
Other
Enumeration date
01/06/2018
Last updated
05/15/2019
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