Provider Demographics
NPI:1003706243
Name:ROUSSEL, SHELBY LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:ROUSSEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:RESERVE
Mailing Address - State:LA
Mailing Address - Zip Code:70084-5450
Mailing Address - Country:US
Mailing Address - Phone:985-360-6351
Mailing Address - Fax:
Practice Address - Street 1:2820 NAPOLEON AVE STE 220
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-8202
Practice Address - Country:US
Practice Address - Phone:504-703-9640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.025810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist