Individual
MRS. KELLY SOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7215 S SIWELL RD, BYRAM, MS 39272-9776
(601) 373-2204
(601) 373-4413
Mailing address
7215 S SIWELL RD, BYRAM, MS 39272-9776
(601) 373-2204
(601) 373-4413
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R872287
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R872287
LICENSE
MS
Enumeration date
09/04/2008
Last updated
08/19/2020
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