Individual
KELLI WHITE DART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10701 REILEY ST, CLINTON, LA 70722-3507
(225) 683-1350
(225) 683-1359
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-1310
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN103706
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN103706
RN LICENSE
LA
Enumeration date
05/10/2019
Last updated
05/10/2019
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