Doctor Name: | MRS. SHANNON MARGARET STUCKEY |
NPI Number: | 1457791782 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | AP07381 |
Business Practice Address: | 4239 Highway 1192 Suite 100 Marksville, LA - 713514771 |
Business Phone Number: | 3182530866 |
Business Fax Number: | 3182530864 |
Mailing Address: | 137 Ron Mar Dr, PINEVILLE |
State: | LA |
Postal Code: | 713604566 |
Phone Number: | 3182296553 |
Fax Number: | |
NPI Enumeration Date: | 07/01/2013 |
NPI Last Update Date: | 07/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP07381 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |