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General NPI Number Information
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NPI Number | 1245627959
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Entity Type | Individual
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Provider Name | KELSEY ESCHETTE CST,CSFA
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Gender | Female
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 203 PENDLETON DR
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City | HOUMA
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State | LA
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Zip | 70360-3929
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Country | US
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Telephone | 985-805-0921
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Fax |
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Provider Business Mailing Address
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Address Line | 203 PENDLETON DR
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City | HOUMA
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State | LA
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Zip | 70360-3929
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Country | US
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Telephone | 985-805-0921
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 140601
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 140601
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License Number State | LA
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