Provider Demographics
NPI:1285631085
Name:SAVANT, SHELLY NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:SHELLY
Middle Name:NICOLE
Last Name:SAVANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:324 SETTLERS TRACE BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6084
Mailing Address - Country:US
Mailing Address - Phone:337-456-2403
Mailing Address - Fax:337-412-6436
Practice Address - Street 1:324 SETTLERS TRACE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6084
Practice Address - Country:US
Practice Address - Phone:337-456-2403
Practice Address - Fax:337-412-6436
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0255642084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry