Organization
KELLY VELASQUEZ PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER, LLC
Active
Other names
DeSoto Psychiatric Care
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY LYNN VELASQUEZ PMHNP (OWNER)
(901) 568-8843
Entity
Organization
Contact information
Practice address
7185 SWINNEA RD, SOUTHAVEN, MS 38671-6003
(901) 568-8843
Mailing address
1651 WOOD LANE DR, OLIVE BRANCH, MS 38654-7355
(901) 568-8843
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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