Individual
MRS. KELLY SMITH CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
817 ARDENNES CT, SHREVEPORT, LA 71115-4613
(318) 347-6220
Mailing address
2539 VIKING DRIVE, SUITE 101, BOSSIER CITY, LA 71111-2165
(318) 747-8100
(318) 932-8939
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06750
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2197959
—
LA
Enumeration date
02/23/2012
Last updated
04/08/2020
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