Individual
KELLY LYNN MISHMASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1011 S MOUNT CARMEL PL, PITTSBURG, KS 66762-6604
(620) 670-6710
Mailing address
3011 N MICHIGAN ST, PITTSBURG, KS 66762-2546
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2017026463
MO
163W00000X
Registered Nurse
86657
KS
363LF0000X
Family Nurse Practitioner
Primary
79453
KS
Other
Enumeration date
05/06/2020
Last updated
06/14/2022
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