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Individual

SHANNON DALE HANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
19503 LAKE CHARLES HWY, DERIDDER, LA 70634-2313
(337) 918-0422
(337) 234-3484
Mailing address
19503 LAKE CHARLES HWY, DERIDDER, LA 70634-2313
(337) 918-0422
(337) 234-3484

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
202005
LA
363LF0000X
Family Nurse Practitioner
Primary
F1081710
LA

Other

Enumeration date
12/26/2018
Last updated
03/21/2024
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