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1013169093
SHANNON RENEE GULLY
SHREVEPORT, LA
NPI
1013169093
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: LA 05628)
Enumeration Date
2008-10-21
Last Update Date
2008-10-21
Business Address
Ms. SHANNON RENEE GULLY FNP
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-221-8411
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Mailing Address
Ms. SHANNON RENEE GULLY FNP
9319 BELDEN DR
SHREVEPORT, LA 71118-3538
Phone number: 318-671-7846
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