Provider Demographics
NPI:1538524160
Name:ADAMS, KEITRESS
Entity type:Individual
Prefix:
First Name:KEITRESS
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WHITNEY AVE
Mailing Address - Street 2:BLDGE. 20 APT. 404
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-3310
Mailing Address - Country:US
Mailing Address - Phone:504-510-1535
Mailing Address - Fax:
Practice Address - Street 1:2700 WHITNEY AVE
Practice Address - Street 2:BLDGE. 20 APT. 404
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058
Practice Address - Country:US
Practice Address - Phone:504-446-0293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-26
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator