Individual
KEYOTA ANDREA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2408 HOUMA BLVD APT 315, METAIRIE, LA 70001
(504) 261-2811
Mailing address
7001 BUNDY RD APT R10, NEW ORLEANS, LA 70127-2173
(504) 261-2811
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
0083422717
LA
Other
Enumeration date
08/28/2018
Last updated
09/05/2018
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