Individual
KELLY D CRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4809 AMBASSADOR CAFFERY PKWY STE 410, LAFAYETTE, LA 70508-8802
(337) 470-4881
(337) 470-4882
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(337) 470-4881
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
214884
LA
363L00000X
Nurse Practitioner
903261
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214884
LICENSE
LA
01
—
640604703
LAKELAND SURGICAL CLINIC, PLLC
MS
Enumeration date
12/17/2019
Last updated
08/08/2024
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