Individual
KELLY CHAMBERS MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9001 SUMMA AVE, BATON ROUGE, LA 70809-3726
(225) 761-5200
Mailing address
18556 FAIRWAY OAKS CT, BATON ROUGE, LA 70809-6751
(985) 778-1342
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP0556
LA
Other
Enumeration date
11/21/2015
Last updated
11/21/2015
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