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General NPI Number Information
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NPI Number | 1801128616
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Entity Type | Individual
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Provider Name | ELISE KAYSER KOWALEWSKI PA
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Gender | Female
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 7925 YOUREE DR
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City | SHREVEPORT
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State | LA
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Zip | 71105-5127
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Country | US
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Telephone | 318-212-3610
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Fax | 318-212-3672
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Provider Business Mailing Address
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Address Line | 7925 YOUREE DR SUITE 200
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City | SHREVEPORT
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State | LA
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Zip | 71105-5127
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Country | US
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Telephone | 318-212-3610
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Fax | 318-212-3709
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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 | PA150304
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA200535
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License Number State | LA
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