Healthcare Provider Details

I. General information

NPI: 1598087827
Provider Name (Legal Business Name): SHELLY LOBELL MATHERNE WHNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 CORPORATE DR STE C
HOUMA LA
70360-2514
US

IV. Provider business mailing address

430 CORPORATE DR STE C
HOUMA LA
70360-2514
US

V. Phone/Fax

Practice location:
  • Phone: 985-851-1001
  • Fax: 985-851-1017
Mailing address:
  • Phone: 985-851-1001
  • Fax: 985-851-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN102935-AP06037
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: