Individual
KELLI BEARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1502 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 332-9872
Mailing address
9 PINE CIRCLE, INDIANOLA, MS 38751
(662) 836-4310
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R882184
MS
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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