Individual
MRS. ADA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
110 WILDWOOD BLVD, JACKSON, MS 39212-9614
(601) 291-0342
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901802
MS
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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