Individual
MRS. KELLY LYNN VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
6858 SWINNEA RD BLDG 3B, SOUTHAVEN, MS 38671-9493
(662) 420-2418
(855) 529-1633
Mailing address
1651 WOOD LANE DR, OLIVE BRANCH, MS 38654-7355
(901) 568-8843
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
905496
MS
Other
Enumeration date
08/18/2022
Last updated
01/01/2025
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