Most Relevant Information
Provider Data
| NPI Number: | 1003271073 |
| Provider Name: | SHAMEEKA KELLY |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 83001 |
Most Important Dates
| Enumeration Date: | 12/17/2015 |
| Last Updated: | 12/17/2015 |
Provider Practice Location
124 CHESTER LEVEE RD
JACKSON
TN
383017562
Practice Location Phone/Fax
| Phone: | 7313438684 |
| Fax: |
Provider Mailing Location
124 CHESTER LEVEE RD
JACKSON
TN
383017562
Provider Mailing Phone/Fax
| Phone: | 7313438684 |
| Fax: |