Provider Demographics
NPI:1689092223
Name:MORRIS, SHANNON (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 UTICA ST
Mailing Address - Street 2:STE 100
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-6530
Mailing Address - Country:US
Mailing Address - Phone:504-457-3687
Mailing Address - Fax:504-620-0250
Practice Address - Street 1:4409 UTICA ST
Practice Address - Street 2:STE 100
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-6530
Practice Address - Country:US
Practice Address - Phone:504-457-3687
Practice Address - Fax:504-620-0250
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07764363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology