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Individual

MRS. KISSLEY BOOKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, APRN, FNP-C

Contact information

Practice address
11764 HAYMARKET AVE, BATON ROUGE, LA 70816-6009
(225) 256-5200
Mailing address
20051 OLD SCENIC HWY, APT 1805, ZACHARY, LA 70791-7369
(225) 306-5737

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08729
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2433792
LA
01
540405ZSC1
MEDICARE
LA
Enumeration date
03/11/2016
Last updated
08/04/2023
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