Individual
KELLY ELIZABETH NASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 N STATE ST STE 270, JACKSON, MS 39202-2027
(601) 714-6470
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(901) 227-3206
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904096
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982200911
NPI
CA
Enumeration date
12/06/2020
Last updated
06/05/2024
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