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Individual

KELLY RHODES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C, AGACNP-BC

Contact information

Practice address
3265 HIGHWAY 90, GAUTIER, MS 39553-5121
(228) 366-9136
(228) 366-9137
Mailing address
3265 HIGHWAY 90, GAUTIER, MS 39553-5121
(228) 366-9136

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R858829
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09457208
MS
Enumeration date
07/03/2013
Last updated
04/24/2021
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