Individual
SHAWNA NIKIA JEIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 211, BATON ROUGE, LA 70808-4300
(225) 765-7163
(225) 765-7164
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-4278
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.200050
LA
363AM0700X
Medical Physician Assistant
200050
LA
363AS0400X
Surgical Physician Assistant
Primary
146
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1355615
—
LA
Enumeration date
10/20/2005
Last updated
06/22/2022
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