Individual
KEIFFER ELLIS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
148 WALL BLVD, GRETNA, LA 70056-7107
(504) 393-2273
Mailing address
112 SUMMER CYPRESS LN, BELLE CHASSE, LA 70037-1691
(504) 251-8417
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
205547
LA
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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