Provider Demographics
NPI:1114704533
Name:CONDOL, SHABRITTANEY LAUREL (RNC-OB)
Entity Type:Individual
Prefix:
First Name:SHABRITTANEY
Middle Name:LAUREL
Last Name:CONDOL
Suffix:
Gender:F
Credentials:RNC-OB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 SHARON ST
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-2508
Mailing Address - Country:US
Mailing Address - Phone:225-508-8604
Mailing Address - Fax:
Practice Address - Street 1:915 SHARON ST
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-2508
Practice Address - Country:US
Practice Address - Phone:225-508-8604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN157109163WX0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk