Provider Demographics
NPI:1003120742
Name:KHAN, SHAUNTEL PARKER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHAUNTEL
Middle Name:PARKER
Last Name:KHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SHAUNTEL
Other - Middle Name:MONIQUE
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5104 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-2860
Mailing Address - Country:US
Mailing Address - Phone:504-309-5664
Mailing Address - Fax:
Practice Address - Street 1:5610 READ BLVD STE 113
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127
Practice Address - Country:US
Practice Address - Phone:504-241-8188
Practice Address - Fax:504-264-5941
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18452183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist