Provider Demographics
NPI:1598392086
Name:MENIER, KELLY ELIZABETH SCOTT
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ELIZABETH SCOTT
Last Name:MENIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ELIZABETH
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5246 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9136
Mailing Address - Country:US
Mailing Address - Phone:225-757-4210
Mailing Address - Fax:
Practice Address - Street 1:5246 BRITTANY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9136
Practice Address - Country:US
Practice Address - Phone:225-757-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program