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1154951739
HAILEY DANIELS KELLY
JACKSON, MS
NPI
1154951739
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Former Name
HAILEY DANIELS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: MS PA00468)
Enumeration Date
2020-01-22
Last Update Date
2020-07-06
Business Address
HAILEY DANIELS KELLY PA-C
1325 E FORTIFICATION ST
JACKSON, MS 39202-2442
Phone number: 601-354-4488
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Mailing Address
HAILEY DANIELS KELLY PA-C
2010 HIGHPOINTE DR APT 187
BRANDON, MS 39042-2924
Phone number: 601-951-9070
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