Individual
MR. KERRY L WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2495 SHREVEPORT HIGHWAY, VA MEDICAL, PINEVILLE, LA 71306-9004
(318) 473-0010
Mailing address
8215 HIGHWAY 71 S, LECOMPTE, LA 71346-4704
(318) 473-1964
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN68676APO4120
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1143715
—
LA
01
—
4C428
MEDICARE-PTAN
LA
Enumeration date
08/31/2006
Last updated
09/17/2013
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