Individual
KELBY FRIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 623-9335
Mailing address
638 BAY CITY RD, ELIZABETH, LA 70638-4009
(318) 623-9335
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN158940
LA
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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