Individual
KELSIE RAE CHISOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2124 14TH ST, MERIDIAN, MS 39301-4040
(601) 553-6000
Mailing address
15043 HIGHWAY 503, DECATUR, MS 39327-9680
(601) 479-5890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
897243
MS
363L00000X
Nurse Practitioner
Primary
906102
MS
Other
Enumeration date
06/16/2023
Last updated
05/22/2025
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