Basic Information
| Provider Information | |||||||||
| NPI: | 1700347531 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BATISTE | ||||||||
| FirstName: | SHANTEL | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 GAUSE BLVD STE C4 | ||||||||
| Address2: | |||||||||
| City: | SLIDELL | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704583041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9852886419 | ||||||||
| FaxNumber: | 8778898818 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 GAUSE BLVD STE C4 | ||||||||
| Address2: | |||||||||
| City: | SLIDELL | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704583041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9852886419 | ||||||||
| FaxNumber: | 8778898818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2019 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QH0002X | 204207 | LA | N | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | 207R00000X | 204207 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 363LF0000X | 204207 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.