Provider Demographics
NPI:1760123467
Name:BURRELL-CRAIGE, SHINELL LYNN (CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:SHINELL
Middle Name:LYNN
Last Name:BURRELL-CRAIGE
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 S I 10 SERVICE RD W STE 117
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-7427
Mailing Address - Country:US
Mailing Address - Phone:504-841-0007
Mailing Address - Fax:504-841-0023
Practice Address - Street 1:4300 S I 10 SERVICE RD W STE 117
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7427
Practice Address - Country:US
Practice Address - Phone:504-841-0007
Practice Address - Fax:504-841-0023
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty