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Individual

SHACARRIA NASHELLE OWENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
7505 PINES RD STE 1200-E, SHREVEPORT, LA 71129-3935
(318) 762-1667
Mailing address
7505 PINES RD STE 1200-E, SHREVEPORT, LA 71129-3935
(318) 762-1667

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20170348
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20170348
LICENSED PRACTICAL NURSE
Enumeration date
03/23/2020
Last updated
12/27/2020
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