Land, Kelly K

Land, Kelly K is an individual health care provider with primary practice located at 2500 North State St Department Of Medicine Division Of General Internal Med, Jackson MS 39216. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Land, Kelly K can be contacted via phone (601) 984-5660.

Contact Information

Primary practice address
2500 North State St Department Of Medicine Division Of General Internal Med Jackson MS 39216
Phone: (601) 984-5660
Fax: (601) 984-6870
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R855212 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R855212 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R855212 Massachusetts

Profile Details

NPI number 1154369700
LBN Legal business name Land, Kelly K
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Apr 10th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154369700 NPPES
Mississippi MEDICAID 0124222

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