KELLIE DUVALL SOUTHER

MOCKSVILLE, NC
NPI1558846527
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: NC  5011023)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: NC  5011023)
Enumeration Date2018-09-26
Last Update Date2023-12-05
Business Address
KELLIE DUVALL SOUTHER
1188 YADKINVILLE RD
MOCKSVILLE, NC 27028-2037
Phone number: 336-716-7435
Mailing Address
KELLIE DUVALL SOUTHER
100 KIMEL FOREST DR
WINSTON SALEM, NC 27103-6074
Phone number: 336-713-0947