Healthcare Provider Details
I. General information
NPI: 1497920896
Provider Name (Legal Business Name): SHONDA KNOX SPIRES B.S., RRT-NPS, CPFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/25/2008
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
510 E STONER AVE RESPIRATORY THERAPY
SHREVEPORT LA
71101-4243
US
IV. Provider business mailing address
510 E STONER AVE RESPIRATORY THERAPY
SHREVEPORT LA
71101-4243
US
V. Phone/Fax
- Phone: 318-221-8411
- Fax:
- Phone: 318-221-8411
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2279G1100X |
| Taxonomy | General Care Registered Respiratory Therapist |
| License Number | RRT.L01317 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225B00000X |
| Taxonomy | Pulmonary Function Technologist |
| License Number | RRT.L01317 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: