| NPI | 1215347182 |
|---|---|
| Former Name | KELLIE BREAUX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP07752) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN121064) |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2015-03-17 |