Provider Demographics
NPI:1891106084
Name:MCCALL, KARI S (NP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:S
Last Name:MCCALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:LEIGH
Other - Last Name:SITTIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:501 DR MICHAEL DEBAKEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5724
Mailing Address - Country:US
Mailing Address - Phone:337-312-8258
Mailing Address - Fax:337-312-6708
Practice Address - Street 1:1747 IMPERIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5362
Practice Address - Country:US
Practice Address - Phone:337-721-7236
Practice Address - Fax:337-721-7237
Is Sole Proprietor?:No
Enumeration Date:2014-05-10
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07800363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2367013Medicaid
LA2367013Medicaid
LA348349YH5NMedicare PIN