Individual
HAILEY DANIELS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
Mailing address
2010 HIGHPOINTE DR APT 187, BRANDON, MS 39042-2924
(601) 951-9070
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00468
MS
Other
Enumeration date
01/22/2020
Last updated
07/06/2020
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