Individual
SHANNEL SMITH SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5001 NEW YORK CIR, NEW ORLEANS, LA 70126-1032
(504) 377-3804
Mailing address
5001 NEW YORK CIR, NEW ORLEANS, LA 70126-1032
(504) 377-3804
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84-4532591
IRS
LA
Enumeration date
01/31/2020
Last updated
01/31/2020
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