Individual
KELLIE BOURG PADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
931 VERONE TER, LEESVILLE, LA 71446-4272
(337) 404-1708
(337) 404-1709
Mailing address
PO BOX 730, DERIDDER, LA 70634-0730
(337) 462-7138
(337) 462-7435
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN105307-AP05784
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2572555
—
LA
Enumeration date
04/07/2009
Last updated
02/27/2026
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