Individual
MRS. KELLY CALLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4150 NELSON RD, BUILDING E SUITE 1, LAKE CHARLES, LA 70605-4148
(337) 474-1386
Mailing address
4150 NELSON RD, BUILDING E SUITE 1, LAKE CHARLES, LA 70605-4148
(337) 474-1386
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07995
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2381393
—
LA
Enumeration date
10/01/2014
Last updated
02/01/2016
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