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1013258896
LISA NICOLE KELLOGG
SHREVEPORT, LA
NPI
1013258896
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA AP07151)
Enumeration Date
2013-03-04
Last Update Date
2016-09-09
Business Address
Ms. LISA NICOLE KELLOGG CRNA
1541 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-675-5000
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Mailing Address
Ms. LISA NICOLE KELLOGG CRNA
9329 CASTLEBROOK DR
SHREVEPORT, LA 71129-4807
Phone number: 318-458-9568
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