Individual
KELLY C GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 JUDGE TANNER BLVD STE 300, COVINGTON, LA 70433-7506
(985) 867-2100
(985) 987-1815
Mailing address
LCMC HEALTH - PAYOR ENROLLMENTS, 1100 POYDRAS ST., STE. 2500, NEW ORLEANS, LA 70163-2500
(504) 527-9953
(504) 527-9950
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP232171
LA
Other
Enumeration date
10/16/2023
Last updated
03/13/2024
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