Healthcare Provider Details

I. General information

NPI: 1033403944
Provider Name (Legal Business Name): COURTNEY LYN SHAPPLEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY LYN ROSKI

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-3925
  • Fax: 504-842-6627
Mailing address:
  • Phone: 504-842-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO.000434
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO.1315
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberDO.000434
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: