Individual
KELLY SUSANNE MASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2798 PASS RD, BILOXI, MS 39531-2626
(228) 200-0340
(228) 200-0341
Mailing address
2113 GOVERNMENT ST, BUILDING I-4, OCEAN SPRINGS, MS 39564-3954
(228) 818-0025
(228) 818-0027
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R860508
MS
Other
Enumeration date
03/08/2007
Last updated
01/19/2023
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