MEDICARE: KELLY WARING N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP08673	LA

General Provider Information

NPI Number	:	1639538267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY WARING N.P.

Provider Business Mailing Address
First Line	:	PO BOX 12484
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71315-2484
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2108 TEXAS AVE
Second Line	:	SUITE 2061
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-3944
Country	:	US
Telephone Number	:	318-448-1041
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2016
Last Update Date	:	06/02/2026

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