Provider Demographics
NPI:1790376036
Name:SHELMIRE, DEBVIN JOHNSON
Entity Type:Individual
Prefix:MRS
First Name:DEBVIN
Middle Name:JOHNSON
Last Name:SHELMIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7085 LAKECREST DR
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2771
Mailing Address - Country:US
Mailing Address - Phone:225-354-6400
Mailing Address - Fax:
Practice Address - Street 1:7085 LAKECREST DR
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2771
Practice Address - Country:US
Practice Address - Phone:225-354-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator