Provider Demographics
NPI:1144561408
Name:SHOUN, ROBIN MARY (NP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARY
Last Name:SHOUN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:MARY
Other - Last Name:BOUDREAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11424 SULLIVAN RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-3615
Mailing Address - Country:US
Mailing Address - Phone:225-261-9790
Mailing Address - Fax:
Practice Address - Street 1:11424 SULLIVAN RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818-3615
Practice Address - Country:US
Practice Address - Phone:225-261-9790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07242363LF0000X
LARN062903363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily