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Individual

MRS. SUSAN CASELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
25 S FOURTH ST, ROLLING FORK, MS 39159-5146
(662) 873-0477
(662) 873-0742
Mailing address
373 SAGO ROAD RT. 1, BOX 74N, ANGUILLA, MS 38721
(662) 873-4666

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R604569
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00122933
MS
Enumeration date
06/08/2005
Last updated
03/26/2014
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