Individual
KEN L GREMILLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3100 FORSYTHE AVE, MONROE, LA 71201-3014
(318) 966-6800
(318) 966-6801
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(318) 966-6800
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
204586
LA
Other
Enumeration date
04/16/2019
Last updated
12/29/2023
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