Individual
LAKEN DESONIER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3649 S BEGLIS PKWY, 3645 S. BEGLIS PKWY, SULPHUR, LA 70665-8107
(337) 476-3149
Mailing address
3649 S BEGLIS PKWY, 3645 S. BEGLIS PKWY, SULPHUR, LA 70665-8107
(337) 476-3149
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08194
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2384678
—
LA
Enumeration date
03/10/2015
Last updated
12/01/2016
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