Individual
KRISTA PHILLIPS CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3501 HIGHWAY 10, JACKSON, LA 70748-6238
(225) 683-5292
(225) 683-3411
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-3411
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP05081
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1409723
—
LA
Enumeration date
02/06/2007
Last updated
05/22/2012
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