Organization
ENHANCED WELLNESS LIVING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY B ENGELMANN CFNP (OWNER)
(601) 364-1132
Entity
Organization
Contact information
Practice address
1855 LAKELAND DR, STE M20, JACKSON, MS 39216-4913
(601) 364-1132
(601) 364-1134
Mailing address
1855 LAKELAND DR, STE M20, JACKSON, MS 39216-4913
(601) 364-1132
(601) 364-1134
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R805546
MS
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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