Individual
KELLI WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 COWLES CREEK RD, CLINTON, MS 39056-6244
(618) 713-3185
Mailing address
117 COWLES CREEK RD, CLINTON, MS 39056-6244
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905038
MS
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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