Provider Demographics
NPI:1699728998
Name:MCSHAN, KEVIN PATRICK (MS,, AT, C)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:PATRICK
Last Name:MCSHAN
Suffix:
Gender:M
Credentials:MS,, AT, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3734 LOYOLA DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-7753
Mailing Address - Country:US
Mailing Address - Phone:504-862-8047
Mailing Address - Fax:
Practice Address - Street 1:JAMES W. WILSON CENTER
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118
Practice Address - Country:US
Practice Address - Phone:504-862-8047
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer