Individual
KELLY MASSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
70 MEDICAL PLZ, EUPORA, MS 39744-4018
(662) 258-9400
(662) 258-9435
Mailing address
70 MEDICAL PLZ, EUPORA, MS 39744-4018
(662) 258-9400
(662) 258-9435
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R863259
MS
Other
Enumeration date
05/14/2014
Last updated
05/14/2014
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