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1902030273
SHANNON LEONNIE YOUNGBLOOD
SHREVEPORT, LA
NPI
1902030273
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA AP05726)
Enumeration Date
2009-05-14
Last Update Date
2020-04-13
Business Address
SHANNON LEONNIE YOUNGBLOOD CRNA
1 SAINT MARY PL PFS-PRO BILLING
SHREVEPORT, LA 71101-4343
Phone number: 318-681-6878
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Mailing Address
SHANNON LEONNIE YOUNGBLOOD CRNA
PO BOX 5887
ALEXANDRIA, LA 71307-5887
Phone number: 318-442-5399
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