Individual
DR. KENEITRA BROWN ROUSSELL
Active
Individual
DR. KENEITRA BROWN ROUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
PA200279
LA
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA.200279
LOUISIANA STATE BOARD OF MEDICAL EXAMINERS
LA
Enumeration date
07/25/2008
Last updated
05/21/2025
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