Provider Demographics
NPI:1881974129
Name:SHIELDS, CHAD A (APRN)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:A
Last Name:SHIELDS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1162 OLIVER ROAD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5755
Mailing Address - Country:US
Mailing Address - Phone:318-325-7007
Mailing Address - Fax:318-699-9838
Practice Address - Street 1:1162 OLIVER ROAD
Practice Address - Street 2:SUITE 7
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5755
Practice Address - Country:US
Practice Address - Phone:318-325-7007
Practice Address - Fax:318-699-9838
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LARN122346- AP06503363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily