Individual
KELLIE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5700
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
907202
MS
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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