Provider Demographics
NPI:1194216465
Name:GILBERT, SHANNE (RPT,RMA)
Entity Type:Individual
Prefix:MS
First Name:SHANNE
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:RPT,RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GALLERIA BLVD STE 1900
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-7553
Mailing Address - Country:US
Mailing Address - Phone:337-595-5116
Mailing Address - Fax:800-541-8319
Practice Address - Street 1:104 WESTMARK BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7344
Practice Address - Country:US
Practice Address - Phone:504-656-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy