Individual
DR. SHANNON C PICKENS
Active
Individual
DR. SHANNON C PICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
025591
LA
208D00000X
General Practice Physician
MD025591
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1050342
—
LA
01
—
MD025591
MEDICAL LICENSE
LA
Enumeration date
10/29/2007
Last updated
09/19/2023
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