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General NPI Number Information
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NPI Number | 1942287867
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Entity Type | Individual
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Provider Name | KELLI R CHUNN ACNP
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Gender | Female
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 106 W MAIN ST
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City | LOUISVILLE
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State | MS
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Zip | 39339-2620
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Country | US
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Telephone | 662-773-5704
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Fax | 662-773-9463
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Provider Business Mailing Address
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Address Line | PO BOX 470
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City | LOUISVILLE
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State | MS
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Zip | 39339-0470
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Country | US
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Telephone | 662-773-6211
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Fax | 662-446-1039
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R762267
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License Number State | MS
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