Individual
JENNA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(504) 842-3000
Mailing address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(504) 842-3000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP07868
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07731735
—
MS
05
—
2373510
—
LA
Enumeration date
08/18/2014
Last updated
09/10/2015
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