Provider Demographics
NPI:1215496849
Name:LOUIS, SHELLY
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:
Last Name:LOUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 HOYT ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2561
Mailing Address - Country:US
Mailing Address - Phone:347-334-1560
Mailing Address - Fax:718-260-8253
Practice Address - Street 1:175 HOYT ST APT 2D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2561
Practice Address - Country:US
Practice Address - Phone:347-334-1560
Practice Address - Fax:347-227-7821
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula