Individual
DR. SHANNON TROY HIDALGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-BC
Contact information
Practice address
550 EAST SALE ROAD, LAKE CHARLES, LA 70609-5052
(337) 475-5748
(337) 478-6196
Mailing address
MSU BOX 90735, LAKE CHARLES, LA 70609-0001
(337) 475-5748
(337) 478-6196
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04423
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1466158
—
LA
Enumeration date
04/13/2006
Last updated
06/29/2020
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