Individual
MISS KEILA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R888285
MS
363LG0600X
Gerontology Nurse Practitioner
R888285
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05800329
—
MS
Enumeration date
02/03/2014
Last updated
10/24/2014
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