Individual
MS. LISA NICOLE KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
9329 CASTLEBROOK DR, SHREVEPORT, LA 71129-4807
(318) 458-9568
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP07151
LA
Other
Enumeration date
03/04/2013
Last updated
09/09/2016
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