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General NPI Number Information
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NPI Number | 1366581084
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Entity Type | Individual
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Provider Name | SHANNAN DAVIS BROWN LMT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1232 S MORRISON BLVD
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City | HAMMOND
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State | LA
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Zip | 70403-5702
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Country | US
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Telephone | 985-340-0044
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Fax | 208-248-4170
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Provider Business Mailing Address
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Address Line | 39229 KEAGHEY RD
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City | PONCHATOULA
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State | LA
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Zip | 70454-4641
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Country | US
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Telephone | 985-634-1687
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Fax | 208-248-4170
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | LA1640
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License Number State | LA
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