MEDICARE: SHAMRIKA RENEE HORTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach		LA
2	335E00000X	Prosthetic/Orthotic Supplier		LA

General Provider Information

NPI Number	:	1952090839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMRIKA RENEE HORTON

Provider Business Mailing Address
First Line	:	9009 LONE OAK DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71118-2443
Country	:	US
Telephone Number	:	844-496-4231
Fax Number	:	318-309-1988

Provider Business Practice Location Address
First Line	:	9009 LONE OAK DR
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71118-2443
Country	:	US
Telephone Number	:	844-496-4231
Fax Number	:	318-309-1988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2023
Last Update Date	:	03/19/2026

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