Shelby Lynn Assavedo

Individual provider Active NPI Family Nurse Practitioner · Violet, LA

NPI 1265289672 · NPPES record last updated May 2, 2024

Key facts

NPI
1265289672
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
00001 (LA)
Practice address
2405 S Lake Blvd
Violet, LA 70092-3511
Phone
(504) 909-0374
NPI assigned
May 2, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
00001LAMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 00001 LA Yes

Addresses

Primary practice location

2405 S Lake Blvd
Violet, LA 70092-3511

Mailing address

2405 S Lake Blvd
Violet, LA 70092-3511

Other providers in Violet, LA

All providers in Violet, LA · Family Nurse Practitioner in Louisiana

Sources for this page

Verify at the official NPI Registry.