Individual
KELSAY DAWNE MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4203 LISA ST, ALEXANDRIA, LA 71302-2410
(318) 545-7845
Mailing address
PO BOX 1288, WINNFIELD, LA 71483-1288
(318) 209-4501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
226959
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2021
Last updated
07/28/2022
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