Provider Demographics
NPI:1205118056
Name:JOLLANDS, KERI LYNN
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:LYNN
Last Name:JOLLANDS
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 1:822 S CLEARVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-3401
Mailing Address - Country:US
Mailing Address - Phone:504-736-1864
Mailing Address - Fax:504-484-8189
Practice Address - Street 1:822 S CLEARVIEW PKWY
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-3401
Practice Address - Country:US
Practice Address - Phone:504-736-1865
Practice Address - Fax:504-484-8189
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z12469174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist