Provider Demographics
NPI:1174016679
Name:LIGHTELL, SHELIA MARIE
Entity Type:Individual
Prefix:MS
First Name:SHELIA
Middle Name:MARIE
Last Name:LIGHTELL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHELIA
Other - Middle Name:MARIE
Other - Last Name:LIGHTELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRT
Mailing Address - Street 1:1317 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-4511
Mailing Address - Country:US
Mailing Address - Phone:504-931-4149
Mailing Address - Fax:
Practice Address - Street 1:1317 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-4511
Practice Address - Country:US
Practice Address - Phone:504-931-4149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)