Provider Demographics
NPI:1295187847
Name:DUFRENE, SHANNON BROUPHY (DNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:BROUPHY
Last Name:DUFRENE
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 S CLAIBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-4105
Mailing Address - Country:US
Mailing Address - Phone:504-864-8080
Mailing Address - Fax:
Practice Address - Street 1:6225 S CLAIBORNE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4105
Practice Address - Country:US
Practice Address - Phone:504-864-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily