Individual
STEPHANIE MCCOLLISTER KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
888 TARA BLVD, STE. E, BATON ROUGE, LA 70806-7818
(225) 926-4400
(225) 926-4409
Mailing address
888 TARA BLVD, STE. E, BATON ROUGE, LA 70806-7818
(225) 926-4400
(225) 926-4409
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
024325
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1570214
—
LA
Enumeration date
07/05/2006
Last updated
07/08/2007
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