Individual
SHANE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
10059 N REIGER RD, BATON ROUGE, LA 70809-4559
(225) 456-2330
Mailing address
10059 N REIGER RD, BATON ROUGE, LA 70809-4559
(225) 456-2330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07854
LA
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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