Provider Demographics
NPI:1124689047
Name:COENEN, DEBRA CAROLINE (NP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:CAROLINE
Last Name:COENEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:COENEN
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 DESIARD ST STE 355
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7363
Mailing Address - Country:US
Mailing Address - Phone:318-807-7875
Mailing Address - Fax:318-812-6603
Practice Address - Street 1:920 OLIVER RD # B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5702
Practice Address - Country:US
Practice Address - Phone:318-807-6267
Practice Address - Fax:318-812-6458
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA206505363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ260278OtherARIZONA STATE BOARD OF NURSING
LA206505OtherLOUISIANA STATE BOARD OF NURSING NP LICENSE