Individual
KELLI SPILLERS BOVARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
8415 GOODWOOD BLVD, SUITE 104, BATON ROUGE, LA 70806-7851
(225) 925-9797
(225) 925-9787
Mailing address
8415 GOODWOOD BLVD, SUITE 104, BATON ROUGE, LA 70806-7851
(225) 925-9797
(225) 925-9787
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN103455 AP04901
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1527467
—
LA
Enumeration date
06/12/2006
Last updated
01/20/2021
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