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General NPI Number Information
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NPI Number | 1932064029
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Entity Type | Individual
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Provider Name | SHANNA MCMULLEN MSN, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 6216 RUTH ST
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City | METAIRIE
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State | LA
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Zip | 70003-4152
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Country | US
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Telephone | 504-419-3761
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Fax |
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Provider Business Mailing Address
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Address Line | 3014 DAUPHINE ST STE A
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City | NEW ORLEANS
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State | LA
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Zip | 70117-6755
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Country | US
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Telephone | 504-419-3761
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN139294
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 242537
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP70048766
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License Number State | WA
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