| Holistic Health With Kelly Llc | |
|
6259 Pinedale Rd Meridian MS 39305-3430 | |
| (601) 616-3752 | |
| Not Available |
| Full Name | Holistic Health With Kelly Llc |
|---|---|
| Speciality | Counselor |
| Location | 6259 Pinedale Rd, Meridian, Mississippi |
| Authorized Official Name and Position | Kelly Harper Smith (OWNER) |
| Authorized Official Contact | 6016163752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Health With Kelly Llc 6259 Pinedale Rd Meridian MS 39305-3430 Ph: (601) 616-3752 | Holistic Health With Kelly Llc 6259 Pinedale Rd Meridian MS 39305-3430 Ph: (601) 616-3752 |
| NPI Number | 1245806041 |
|---|---|
| Provider Enumeration Date | 06/02/2021 |
| Last Update Date | 06/02/2021 |
| Certification Date | 06/02/2021 |
| Medicare PECOS PAC ID | 1850797846 |
|---|---|
| Medicare Enrollment ID | O20210830002828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245806041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Keisha L Oliphant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679710933 PECOS PAC ID: 5698830222 Enrollment ID: I20090216000324 |
| Provider Name | Priscilla M Mathis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174909865 PECOS PAC ID: 7719296755 Enrollment ID: I20151014001870 |
| Provider Name | Kelly H Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407346380 PECOS PAC ID: 9133477698 Enrollment ID: I20180731003757 |
| Provider Name | Kristen M Thames |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407493596 PECOS PAC ID: 5698101798 Enrollment ID: I20200210001003 |
| Provider Name | Lucy M Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659971380 PECOS PAC ID: 9638588692 Enrollment ID: I20210505000068 |
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