person
Mrs. Kellie Smith Lane
Family Nurse Practitioner in Jackson, Mississippi
NPI 1306868708

Kellie Smith Lane is a Family Nurse Practitioner based in Jackson, MS and is specialized in Family. Kellie Smith Lane practices in Jackson, MS. The NPI Number for Kellie Smith Lane is 1306868708 and holds a License No. R865577 (Mississippi).

The current practice location address for Kellie Smith Lane is 3502 W Northside Dr, Jackson, MS and can be reached out via phone at 601-362-5321 and via fax at 601-364-2600.

Location: 3502 W Northside Dr, Jackson, MS, 39213-4454
person
Provider Profile Details
NPI Number
1306868708
Provider Name
Kellie Smith Lane
Credential
Provider Entity Type
Individual
Gender
Female
Address
3502 W Northside Dr, Jackson, MS, 39213-4454
Phone Number
601-362-5321
Fax Number
601-364-2600
Provider Enumeration Date
07/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01425217 05 MS
institution
Provider Business Practice Location Address Details
Address
3502 W Northside Dr
City
State
Zip
39213-4454
Phone Number
601-362-5321
Fax Number
601-364-2600
person
Provider Business Mailing Address Details
Address
3502 W Northside Dr
City
State
Zip
39213-4454
Phone Number
601-362-5321
Fax Number
601-364-2600
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
R865577 (Mississippi)
Definition
Definition to come...
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