Individual
DR. KENEITRA BROWN ROUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3584 W AIRLINE HWY, RESERVE, LA 70084-5708
(985) 200-3836
Mailing address
3584 W AIRLINE HWY, RESERVE, LA 70084-5708
(985) 200-3836
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
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us