Individual
KELLEY C GOWDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4711 POPLAR SPRINGS DRIVE, MERIDIAN, MS 39305
(601) 635-3333
(601) 635-3333
Mailing address
4711 POPLAR SPRINGS DR, MERIDIAN, MS 39305-2622
(601) 545-8700
(601) 582-5461
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R860748
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04424823
—
MS
Enumeration date
11/20/2009
Last updated
07/18/2011
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