Provider Demographics
NPI:1679882286
Name:ALMOND, KELLY (ACNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:ALMOND
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1720 MEDICAL PARK DR # 150
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2131
Mailing Address - Country:US
Mailing Address - Phone:228-392-7429
Mailing Address - Fax:228-396-3830
Practice Address - Street 1:1720 MEDICAL PARK DR
Practice Address - Street 2:340
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2131
Practice Address - Country:US
Practice Address - Phone:228-392-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR870906363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care