Individual
BRITTANY ELAINE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8731 PARK PLAZA DR, SHREVEPORT, LA 71105-5682
(318) 797-5848
(318) 797-5844
Mailing address
8731 PARK PLAZA DR, SHREVEPORT, LA 71105-5682
(318) 797-5848
(318) 797-5844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
303569
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13922838
CAQH
—
Enumeration date
07/27/2016
Last updated
10/04/2024
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