Healthcare Provider Details

I. General information

NPI: 1538096789
Provider Name (Legal Business Name): KERI CAMP DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N LEE DR
GUNTOWN MS
38849-8560
US

IV. Provider business mailing address

121 DRIVE 1455
TUPELO MS
38804-8276
US

V. Phone/Fax

Practice location:
  • Phone: 662-397-4706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1316
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: