Individual
KELLIE MATTINGLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5001 WESTBANK EXPY STE 100, MARRERO, LA 70072-2954
(504) 349-8833
Mailing address
3212 RUE MARCELLE ST., MERAUX, LA 70075
(504) 259-6120
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
223687
LA
Other
Enumeration date
01/05/2022
Last updated
07/29/2022
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