Individual
KATELYN C BOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
499 GLOSTER CREEK VLG STE A1, TUPELO, MS 38801-4749
(662) 432-0700
Mailing address
370 CROWN DR, FULTON, MS 38843-6018
(662) 255-6963
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
903402
MS
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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