Individual
MRS. KEYSHA RAYE NABOURS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 480-8066
(337) 480-8061
Mailing address
PO BOX 122108 DEPT 2108, DALLAS, TX 75312-2108
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06763
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2319205
—
LA
01
—
AP06763
STATE LICENSE
LA
Enumeration date
09/26/2012
Last updated
04/28/2022
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