Individual
SHIREISLA DENAE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
110 CROSS PARK DR, PEARL, MS 39208-9016
(601) 397-6731
Mailing address
855 SPRINGFIELD CT, RIDGELAND, MS 39157-1583
(601) 278-4933
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
908520
MS
Other
Enumeration date
06/22/2026
Last updated
06/22/2026
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