Individual
MRS. KELI WOOD BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 415-0744
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 415-0744
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R880004
MS
Other
Enumeration date
06/15/2011
Last updated
06/15/2012
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