Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Blacka

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1437998663

Shane Blacka is a Student in an Organized Health Care Education/Training Program in Jefferson, Louisiana. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

1514 Jefferson Hwy
Jefferson, LA 70121-2429
Phone: (504) 842-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1437998663
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 20, 2024
Last updated in NPPESMay 20, 2024
Certification dateMay 19, 2024
Mailing address1514 Jefferson Hwy, Jefferson, LA 70121-2429

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