Healthcare Provider Details

I. General information

NPI: 1841851862
Provider Name (Legal Business Name): KATHRYN SHARBONO STANSBURY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KATHRYN RENEE SHARBONO

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 TOWER DR STE 415
MONROE LA
71201-5782
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 318-966-2001
  • Fax: 318-966-2002
Mailing address:
  • Phone: 318-966-2001
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number206507
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number206507
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: