Shannon Dale
Individual provider Active NPI Ambulatory Care Registered Nurse · Haughton, LA
NPI 1730003500 · NPPES record last updated Aug 5, 2026
Key facts
- NPI
- 1730003500
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ambulatory Care Registered Nurse 163WP2201X
- License
- RN123119 (LA)
- Practice address
- 8511 Timberwood LN
Haughton, LA 71037-9377 - Phone
- (318) 935-1900
- NPI assigned
- Aug 5, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | RN123119 | LA | Yes |
Addresses
Primary practice location
8511 Timberwood LN
Haughton, LA 71037-9377
Mailing address
8511 Timberwood LN
Haughton, LA 71037-9377
Phone (318) 935-1900
Other providers in Haughton, LA
- Angela Tapp Coleman
- Matthew Tynes Coleman
- Khaliah Shileen Cook
- Heidi Cram
- Custom Care Therapy and Wellness, Inc.
- Lance Danos
- Shondreika Tenae Davis
- James Claudius Degueurce III
- Paul Alan Edwards
- Elite Medical Resources
All providers in Haughton, LA · Ambulatory Care Registered Nurse in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.