Provider Demographics
NPI:1891988754
Name:FERLAND, SHAUNA NOEL
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:NOEL
Last Name:FERLAND
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 1:4425 JEFFERSON AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-1535
Mailing Address - Country:US
Mailing Address - Phone:870-216-1700
Mailing Address - Fax:
Practice Address - Street 1:4425 JEFFERSON AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-1535
Practice Address - Country:US
Practice Address - Phone:870-216-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse