Individual
MALLORY M MCKERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 214-6438
Mailing address
7777 HENNESSY BLVD STE 301, BATON ROUGE, LA 70808-0319
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
218572
LA
Other
Enumeration date
04/20/2021
Last updated
08/10/2022
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