Individual
KELLY L BECNEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
108 RUE LOUIS XIV, LAFAYETTE, LA 70508-5739
(337) 235-8007
(337) 235-8008
Mailing address
18444 N 25TH AVE, SUITE 310, PHOENIX, AZ 85023-1261
(623) 241-8635
(623) 544-5531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
200551
LA
363AS0400X
Surgical Physician Assistant
200551
LA
Other
Enumeration date
12/02/2009
Last updated
11/05/2015
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