Organization
PRIMARY CARE AT HOME OF LOUISIANA IV, LLC
Active
Other names
Primary Care at Home of Kenner
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD D. STELLY (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
200 W ESPLANADE AVE STE 601, KENNER, LA 70065-2475
(504) 252-3305
(504) 208-3249
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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