| NPI | 1124707765 |
|---|---|
| Other Name | SHANTA SMITH |
| Entity Type | Organization |
| Authorized Contact | VANESSA DOMINGUE Office Manager 337-643-8424 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-07-12 |