Hall, Kelli Danielle Grim

Hall, Kelli Danielle Grim is an individual health care provider with primary practice located at 10310 The Grove Blvd , Baton Rouge LA 70836-6455. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Hall, Kelli Danielle Grim can be contacted via phone (225) 761-5470.

Contact Information

Primary practice address
10310 The Grove Blvd Baton Rouge LA 70836-6455
Phone: (225) 761-5470
Fax: (225) 761-5549
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD.206157 Louisiana

Profile Details

NPI number 1194041152
LBN Legal business name Hall, Kelli Danielle Grim
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2010
Last updated Aug 28th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194041152 NPPES
Louisiana MEDICAID 2108158
Louisiana MEDICAID 02784541

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