Provider Demographics
NPI:1750657144
Name:NAVARRE, SHENTELLE N (RN)
Entity Type:Individual
Prefix:
First Name:SHENTELLE
Middle Name:N
Last Name:NAVARRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2238 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3606
Mailing Address - Country:US
Mailing Address - Phone:985-690-6622
Mailing Address - Fax:985-690-6662
Practice Address - Street 1:2238 1ST ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3606
Practice Address - Country:US
Practice Address - Phone:985-690-6622
Practice Address - Fax:985-690-6662
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN134324163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse