Individual
DR. DEIDRE L. STELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
548 LAKES BLVD, BREAUX BRIDGE, LA 70517-3248
(337) 332-0661
(337) 332-0651
Mailing address
PO BOX 84460, BATON ROUGE, LA 70884-4460
(225) 526-0018
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
022380
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1677655
—
LA
Enumeration date
10/06/2005
Last updated
04/20/2017
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