Individual
SHONTE' PATRICE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 FRONT ST STE 2134, VIDALIA, LA 71373-2834
(318) 336-2212
(318) 336-6067
Mailing address
354 DEACON WAILES RD, FERRIDAY, LA 71334-4300
(713) 247-9574
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F08180268
LA
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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