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Individual

LEAH KETCHUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
317 HIGHWAY 13 S, MORTON, MS 39117-3353
(601) 732-6301
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
903189
MS
363LF0000X
Family Nurse Practitioner
Primary
903189
MS

Other

Enumeration date
02/22/2019
Last updated
04/16/2024
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