Individual
KELLY HAVARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3236 KIRKMAN ST, LAKE CHARLES, LA 70601-8640
(337) 478-6020
Mailing address
10876 HIGHWAY 109, STARKS, LA 70661-5002
(337) 222-0092
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
219543
LA
Other
Enumeration date
04/05/2018
Last updated
07/27/2021
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