Individual provider · Type 1 NPI
Shannon Renee Gully, FNP
Family Nurse Practitioner · Shreveport, LA
NPI number
1013169093
Active
Practice location
510 E Stoner Ave
Shreveport, LA 71101-4243
Mailing address
9319 Belden Dr
Shreveport, LA 71118-3538
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 05628 (LA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1013169093
Shannon Renee Gully, FNP's National Provider Identifier is 1013169093, issued on Oct 21, 2008. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Shreveport, LA. The record was last updated on Oct 21, 2008.