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Shannon Dale Hanks, NP

Nurse Practitioner, Family in Deridder, LA. Individual provider (NPI-1).

NPI number1891267167
StatusActive
Last updated in NPPESMar 21, 2024

Details

NPI
1891267167
Entity type
Individual (NPI-1)
Name
Shannon Dale Hanks
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Dec 26, 2018
Certification date
Mar 21, 2024
Last updated
Mar 21, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyF1081710LAYes
363LF0000X Nurse Practitioner, Family202005LA

Practice location

19503 Lake Charles Hwy
Deridder, LA 70634-2313

Phone 337-918-0422 · Fax 337-234-3484

Mailing address

19503 Lake Charles Hwy
Deridder, LA 70634-2313

Phone 337-918-0422 · Fax 337-234-3484

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Other Family Nurse Practitioner providers in Deridder, LA

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