Provider Demographics
NPI:1851281547
Name:THOMPSON, SHAMARI IMAN (LPM)
Entity type:Individual
Prefix:
First Name:SHAMARI
Middle Name:IMAN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70499 L ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5297
Mailing Address - Country:US
Mailing Address - Phone:225-390-0956
Mailing Address - Fax:
Practice Address - Street 1:711 W CORNERVIEW ST
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3307
Practice Address - Country:US
Practice Address - Phone:225-390-0956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009013164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse