Individual
KELLY CHRISTINE BOAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5439 AIRLINE HWY, BATON ROUGE, LA 70805-1712
(225) 358-4853
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 358-4853
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200456
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165623
—
LA
Enumeration date
06/23/2011
Last updated
02/27/2026
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