Individual
KELLI R CHUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
106 W MAIN ST, LOUISVILLE, MS 39339-2620
(662) 773-5704
(662) 773-9463
Mailing address
PO BOX 470, LOUISVILLE, MS 39339-0470
(662) 773-6211
(662) 446-1039
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R762267
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124186
—
MS
01
—
P00191926
RAILROAD MEDICARE
—
Enumeration date
12/30/2005
Last updated
04/04/2025
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