Individual
KELSI FEDUCCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4699
(601) 200-2000
Mailing address
969 LAKELAND DR, JACKSON, MS 39216-4699
(601) 200-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905770
MS
Other
Enumeration date
03/23/2023
Last updated
04/01/2024
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