Kelly, Brandi J
Kelly, Brandi J is an individual health care provider with primary practice located at 830 W Bayou Pines Dr , Lake Charles LA 70601-7097. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Kelly, Brandi J can be contacted via phone (337) 436-9557.Contact Information
Primary practice address
830 W Bayou Pines Dr
Lake Charles LA 70601-7097
Phone: (337) 436-9557
Fax: (337) 312-1311
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD.201854 | Louisiana |
Profile Details
| NPI number | 1205046414 |
|---|---|
| LBN Legal business name | Kelly, Brandi J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2007 |
| Last updated | Aug 26th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205046414 | NPPES |
| Louisiana | MEDICAID | 1214671 |
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