Provider Demographics
NPI:1831951375
Name:POREE, SHAWANDA (RN)
Entity type:Individual
Prefix:MRS
First Name:SHAWANDA
Middle Name:
Last Name:POREE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6825
Mailing Address - Country:US
Mailing Address - Phone:866-407-6733
Mailing Address - Fax:
Practice Address - Street 1:3725 MACARTHUR BLVD APT 2A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6825
Practice Address - Country:US
Practice Address - Phone:866-407-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN094848163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator