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NPI Code Detail

MEDICARE: KYSHA SALEEM FNP-C

MEDICARE: KYSHA SALEEM FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerR850812MS
2363LF0000XFamily Nurse Practitioner18873TN

General Provider Information

NPI Number : 1245643246
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYSHA SALEEM FNP-C
Provider Business Mailing Address
First Line : 778 LIBERTY RD
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-9300
Country : US
Telephone Number : 769-243-6141
Fax Number :
Provider Business Practice Location Address
First Line : 778 LIBERTY RD
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-9300
Country : US
Telephone Number : 769-243-6141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2014
Last Update Date : 02/02/2024

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Directions to “ KYSHA SALEEM FNP-C” Practice Location

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