Organization
AUDUBON PEDIATRICS, LLC
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE KERLEY M.D. (OWNER)
(985) 688-0238
Entity
Organization
Contact information
Practice address
216 MYSTIC BLVD, SUITE B, HOUMA, LA 70360-2870
(985) 868-9339
Mailing address
216 MYSTIC BLVD, SUITE B, HOUMA, LA 70360-2870
(985) 868-9339
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.024810
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459313
—
LA
Enumeration date
11/21/2006
Last updated
10/06/2011
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