Individual
KECIA LASONIA PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
768 AVERY BLVD N, RIDGELAND, MS 39157-5219
(601) 487-6482
Mailing address
1908 COLONY PARK DR, PEARL, MS 39208-6372
(769) 572-2646
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
902423
MS
Other
Enumeration date
07/08/2018
Last updated
07/08/2018
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