Individual
SHARELL KATELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
648 LATIOLAIS DR, BREAUX BRIDGE, LA 70517-4231
(337) 332-4878
Mailing address
648 LATIOLAIS DR, BREAUX BRIDGE, LA 70517-4231
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
280296
LA
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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