Individual
KELLIE THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Mailing address
830 S GLOSTER ST, 1ST FLOOR EAST TOWER, TUPELO, MS 38801-4934
(662) 377-2395
(662) 377-2397
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
901391
MS
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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