Individual
KELLY PERQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2535 VETERANS BLVD, THIBODAUX, LA 70301-4363
(985) 447-0921
Mailing address
105 SUGAR RIDGE DR, THIBODAUX, LA 70301-9405
(985) 633-2630
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN065638
LA
Other
Enumeration date
06/15/2012
Last updated
06/15/2012
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