Provider Demographics
NPI:1538411103
Name:MEILLEUR-LABEAUD, KELLY (APRN, FNP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MEILLEUR-LABEAUD
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:MEILLEUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 13038
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70185-3038
Mailing Address - Country:US
Mailing Address - Phone:504-207-3060
Mailing Address - Fax:504-212-9548
Practice Address - Street 1:5640 READ BLVD
Practice Address - Street 2:SUITE 550
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3140
Practice Address - Country:US
Practice Address - Phone:504-248-5357
Practice Address - Fax:504-248-5377
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN088734163W00000X
LAAP07085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse