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Individual

MS. KELLY LINER DUKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
2647 S SAINT ELIZABETH BLVD STE 125, GONZALES, LA 70737-5020
(225) 647-9675
(225) 766-2226
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0001
(225) 765-9196

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
200058
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
055655
CDS
LA
05
1581666
LA
01
200058
STATE LICENSE
LA
01
TPA132
STATE MEDICAL LIC
LA
Enumeration date
01/16/2006
Last updated
03/07/2023
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