Kelley, Jennifer

Kelley, Jennifer is an individual health care provider with primary practice located at 2300 Hospital Dr Ste 300 , Bossier City LA 71111. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Kelley, Jennifer can be contacted via phone (318) 212-7793.

Contact Information

Primary practice address
2300 Hospital Dr Ste 300 Bossier City LA 71111
Phone: (318) 212-7793
Fax: (318) 212-7795
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD.206814 Louisiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD.206814 Louisiana

Profile Details

NPI number 1366760993
LBN Legal business name Kelley, Jennifer
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2010
Last updated Jun 17th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366760993 NPPES
Louisiana MEDICAID 2103211
Louisiana Other 362685YH54

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