Healthcare Provider Details

I. General information

NPI: 1295940559
Provider Name (Legal Business Name): KELLY RENEE FINAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 HENNESSY BLVD STE 507
BATON ROUGE LA
70808-4366
US

IV. Provider business mailing address

7777 HENNESSY BLVD STE 507
BATON ROUGE LA
70808-4366
US

V. Phone/Fax

Practice location:
  • Phone: 225-767-1156
  • Fax: 225-767-5980
Mailing address:
  • Phone: 225-767-1156
  • Fax: 225-767-5980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25779
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number203031
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: