Individual
MRS. SHELLY JEAN CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
835 PRIDE DR STE B, HAMMOND, LA 70401-9527
(985) 543-4730
Mailing address
835 PRIDE DR STE B, HAMMOND, LA 70401-9527
(985) 543-4730
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20130461
LA
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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