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1013114842
KELLY ANN WALLS
SHREVEPORT, LA
NPI
1013114842
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: LA 270221)
Enumeration Date
2007-06-27
Last Update Date
2007-07-08
Business Address
Mrs. KELLY ANN WALLS LPN
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-221-8411
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Mailing Address
Mrs. KELLY ANN WALLS LPN
222 COUNTRY CLUB DR
BENTON, LA 71006-9463
Phone number: 318-965-4798
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