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General NPI Number Information
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NPI Number | 1477470284
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Entity Type | Organization
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Legal Business Name | HYDRATION HAVEN LLC
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 842 BEHRMAN HWY STE 103
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City | TERRYTOWN
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State | LA
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Zip | 70056-4546
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Country | US
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Telephone | 504-450-6682
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Fax |
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Provider Business Mailing Address
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Address Line | 842 BEHRMAN HWY STE 103
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City | TERRYTOWN
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State | LA
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Zip | 70056-4546
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Country | US
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Telephone | 504-450-6682
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | SHELBY LYNN FOURROUX
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Credential | FNP
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Telephone | 504-458-6337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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