=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710890967
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHAYLA WHITMORE BSN, RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2026
-----------------------------------------------------
Last Update Date | 09/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9110 OAKWOOD DR
-----------------------------------------------------
City | BASTROP
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71220-4808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-547-5010
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9110 OAKWOOD DR
-----------------------------------------------------
City | BASTROP
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71220-4808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | RN105534
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------