Individual
RUSSELL TRICE SHOULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
(504) 837-9271
Mailing address
414 DEMONTLUZIN AVE, BAY ST LOUIS, MS 39520
(228) 363-3135
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP08258
LA
363LF0000X
Family Nurse Practitioner
R866996
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05487222
—
MS
05
—
2395564
—
LA
Enumeration date
02/27/2013
Last updated
05/10/2026
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