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General NPI Number Information
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NPI Number | 1639987761
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Entity Type | Individual
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Provider Name | KELCIE FREYOU MILLER APRN
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Gender | Female
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 1890 W GAUTHIER RD STE 145
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City | LAKE CHARLES
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State | LA
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Zip | 70605-7600
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Country | US
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Telephone | 337-480-5590
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Fax | 337-480-5591
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Provider Business Mailing Address
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Address Line | 1890 W GAUTHIER RD
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City | LAKE CHARLES
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State | LA
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Zip | 70605-7179
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 234571
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License Number State | LA
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