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General NPI Number Information
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NPI Number | 1275963167
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Entity Type | Individual
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Provider Name | KELLI DOOLEY DAVID APRN, CPNP
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Gender | Female
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 10273 GOULD DRIVE
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City | ST. FRANCISVILLE
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State | LA
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Zip | 70775
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Country | US
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Telephone | 225-635-9065
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Fax | 225-635-9069
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Provider Business Mailing Address
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Address Line | PO BOX 368 - OAK BUILDING
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City | ST. FRANCISVILLE
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State | LA
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Zip | 70775
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Country | US
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Telephone | 225-635-9065
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Fax | 225-635-9069
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN124785
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP07683
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License Number State | LA
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