Provider Demographics
NPI:1063972651
Name:JAMES, SHAWANN YVETTE (LPN)
Entity type:Individual
Prefix:
First Name:SHAWANN
Middle Name:YVETTE
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57805 NEW ERWIN DR
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-2325
Mailing Address - Country:US
Mailing Address - Phone:225-485-4411
Mailing Address - Fax:
Practice Address - Street 1:11745 BRICKSOME AVE STE A3
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2369
Practice Address - Country:US
Practice Address - Phone:225-485-4065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA270542164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse