Provider Demographics
NPI:1700335213
Name:PANNIA, SHIRLEEN WATSON (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEEN
Middle Name:WATSON
Last Name:PANNIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:SHIRLEEN
Other - Middle Name:MARTHA
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2930 CANAL ST STE 401
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6367
Mailing Address - Country:US
Mailing Address - Phone:504-821-2574
Mailing Address - Fax:504-821-2595
Practice Address - Street 1:2930 CANAL STREET
Practice Address - Street 2:SUITE 401
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119
Practice Address - Country:US
Practice Address - Phone:504-821-2574
Practice Address - Fax:504-821-2595
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAF0816930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP09034OtherAPRN