Provider Demographics
NPI:1699502013
Name:KERNER, SHELBY BELLARD (MOT, LOTR)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:BELLARD
Last Name:KERNER
Suffix:
Gender:F
Credentials:MOT, LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1156 JEAN LAFITTE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFITTE
Mailing Address - State:LA
Mailing Address - Zip Code:70067-4102
Mailing Address - Country:US
Mailing Address - Phone:337-692-1752
Mailing Address - Fax:
Practice Address - Street 1:3701 BEHRMAN PL
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-0910
Practice Address - Country:US
Practice Address - Phone:504-367-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA307191225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation