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General NPI Number Information
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NPI Number | 1669317913
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Entity Type | Individual
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Provider Name | KELLY VANCE FIELDS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 1620 BELLE CHASSE HWY STE 101&102
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City | TERRYTOWN
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State | LA
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Zip | 70056-7057
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Country | US
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Telephone | 504-569-5327
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Fax |
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Provider Business Mailing Address
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Address Line | 5573 AVERY DR
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City | MARRERO
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State | LA
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Zip | 70072-5151
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Country | US
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Telephone | 504-813-2644
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 245747
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License Number State | LA
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