Individual
MRS. BROOKE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 419-1958
(337) 419-1947
Mailing address
501 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5724
(337) 312-8258
(337) 312-6708
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN104229 AP04899
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1706329
—
LA
Enumeration date
06/05/2006
Last updated
08/18/2022
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