Individual
SHANNON LEONNIE YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 SAINT MARY PL, PFS-PRO BILLING, SHREVEPORT, LA 71101-4343
(318) 681-6878
(318) 681-7402
Mailing address
PO BOX 5887, ALEXANDRIA, LA 71307-5887
(318) 442-5399
(318) 442-1586
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP05726
LA
Other
Enumeration date
05/14/2009
Last updated
04/13/2020
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