Individual provider · Type 1 NPI

Kellie Smith Lane

Family Nurse Practitioner · Jackson, MS

NPI number 1306868708 Active

Practice location

3502 W Northside Dr
Jackson, MS 39213-4454

Fax (601) 364-2600

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XR865577 (MS)

Family Nurse Practitioner: Definition to come...

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About NPI 1306868708

Kellie Smith Lane's National Provider Identifier is 1306868708, issued on Jul 24, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Jackson, MS. The record was last updated on Jan 5, 2017.