Most Relevant Information
Provider Data
| NPI Number: | 1003652082 |
| Provider Name: | SHAKKIE MARY SHANNON |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/08/2024 |
| Last Updated: | 07/08/2024 |
Provider Practice Location
PO BOX 1831
GRETNA
LA
700541831
Practice Location Phone/Fax
| Phone: | 5043676888 |
| Fax: | 5043676889 |
Provider Mailing Location
PO BOX 1831
GRETNA
LA
700541831
Provider Mailing Phone/Fax
| Phone: | 5043676888 |
| Fax: | 5043676889 |