Healthcare Provider Details

I. General information

NPI: 1215248935
Provider Name (Legal Business Name): ALLISON KENDRICK STELLY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 N PINE RD
OLLA LA
71465-4804
US

IV. Provider business mailing address

1102 N PINE RD
OLLA LA
71465-4804
US

V. Phone/Fax

Practice location:
  • Phone: 318-495-3131
  • Fax: 318-495-0771
Mailing address:
  • Phone: 318-495-3131
  • Fax: 318-495-0771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP06151
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: