Provider Demographics
NPI:1821429465
Name:PREJEAN, SHANA MURPHY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHANA
Middle Name:MURPHY
Last Name:PREJEAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 VILLA DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:LA
Mailing Address - Zip Code:70669-5909
Mailing Address - Country:US
Mailing Address - Phone:337-304-1120
Mailing Address - Fax:337-855-8631
Practice Address - Street 1:120 VILLA DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:LA
Practice Address - Zip Code:70669-5909
Practice Address - Country:US
Practice Address - Phone:337-304-1120
Practice Address - Fax:337-855-8631
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.014355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist