Provider Demographics
NPI:1265897896
Name:ADAMS, KEICHELLE
Entity type:Individual
Prefix:
First Name:KEICHELLE
Middle Name:
Last Name:ADAMS
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 1:376 WESTMEADE DR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7208
Mailing Address - Country:US
Mailing Address - Phone:504-493-9032
Mailing Address - Fax:
Practice Address - Street 1:1836 SAINT BERNARD AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70116
Practice Address - Country:US
Practice Address - Phone:504-943-1857
Practice Address - Fax:504-943-1858
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-26
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator