Individual
JONATHAN SHAWN CAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
2375 GAUSE BLVD E, SLIDELL, LA 70461-4142
(985) 645-9000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
904460
MS
363LF0000X
Family Nurse Practitioner
Primary
229112
LA
363LF0000X
Family Nurse Practitioner
904460
MS
Other
Enumeration date
02/09/2021
Last updated
05/02/2023
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