Individual
KELLI CLEBERT CORKERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1023 W HIGHWAY 30, GONZALES, LA 70737-5002
(225) 765-5500
(225) 647-5342
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0001
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06551
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07508799
—
MS
05
—
2169149
—
LA
Enumeration date
10/18/2011
Last updated
08/24/2021
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