Provider Demographics
NPI:1538401666
Name:BIENVENU-OUBRE, SHAUNA RAYE
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:RAYE
Last Name:BIENVENU-OUBRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:337-470-7840
Mailing Address - Fax:
Practice Address - Street 1:127 ACORN DR STE B
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:LA
Practice Address - Zip Code:70584-6134
Practice Address - Country:US
Practice Address - Phone:337-470-7840
Practice Address - Fax:337-470-7849
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.207438207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine