Provider Demographics
NPI:1932064029
Name:MCMULLEN, SHANNA (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 DAUPHINE ST STE A
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-6755
Mailing Address - Country:US
Mailing Address - Phone:504-419-3761
Mailing Address - Fax:
Practice Address - Street 1:6216 RUTH ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-4152
Practice Address - Country:US
Practice Address - Phone:504-419-3761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-19
Last Update Date:2025-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN139294163W00000X
LA242537363LP0808X
WAAP70048766363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse