Individual
JOI SHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9001 SUMMA AVE, BATON ROUGE, LA 70809-3726
(225) 761-5200
Mailing address
17644 N GREENS AVE, BATON ROUGE, LA 70810-8930
(225) 223-1072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP07754
LA
363LP2300X
Primary Care Nurse Practitioner
Primary
AP07754
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01928553
—
MS
05
—
2376802
—
LA
Enumeration date
07/30/2014
Last updated
09/27/2018
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